It's estimated that 5 million people worldwide, including 1.5 million Americans, have lupus. Are they at risk of the same life-threatening infection?
WebMD asked Chaim Putterman, MD, chief of rheumatology at Montefiore Medical Center and Albert Einstein College of Medicine in the Bronx, N.Y. With colleagues Mohammad Kamran, MD, and Jane Wachs, MD, Putterman recently reported necrotizing fasciitis in eight of the 449 lupus patients treated at their hospital from 1996 through 2007.
Is necrotizing fasciitis really an infection with flesh-eating bacteria?
The bacteria that cause necrotizing fasciitis really do eat flesh. The bacteria eat away at the tissues under the skin and spread rapidly.
There's no single kind of flesh-eating bacteria. The drug-resistant staph germ called MRSA causes a particularly difficult-to-treat form, but many other bacteria may be the cause. Over half the time, more than one kind of bacteria is involved.
Infection usually comes from a cut, penetrating wound, or burn. But it can also occur in previously healthy people who did not suffer broken skin.
The infection affects the outer skin only later in the infection. That means a serious infection can be well advanced before it looks as bad as it is.
"It is this relatively normal appearance of the skin that often causes delay in diagnosis," Putterman and colleagues note in their report.
That may be why 1 in 3 patients with necrotizing fasciitis dies of the infection.
"One reason for the bad prognosis of these patients is a delay in diagnosis," Putterman says. "That comes from a delay in patients seeking care as well as a delay in doctors making a diagnosis."