Flesh-eating infections of the VULVA that can kill in hours on the rise in the UK, top doctors warn
TOP UK doctors have warned of a rise in dangerous flesh-eating infections affecting the vulva.
Detailing cases in a new report, the experts warned of a high fatality rate.
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"Necrotising fasciitis is an uncommon and rapidly progressive surgical emergency," medics from Shrewsbury and Telford Hospital NHS Trust wrote in BMJ Case Reports.
Necrotising fasciitis is a rare and rapidly life-threatening infection in which the flesh rots and dies.
The team said their hospital had seen a worrying rise in the flesh-eating disease in recent years - and they want other gynaecologists to keep an eye out.
Twenty cases had been reported between 2022 and 2024 alone. In contrast, 18 cases were seen in the whole decade before that.
The rare flesh eating disease can develop after a wound - from surgery or something as small as a cut, scrape or insect bite - gets infected.
Bacteria penetrate the deep layers of the skin - known as the fascia, which surrounds and holds muscles, nerves, fat and blood vessels in place - spreading quickly and causing them to die.
Bill Sullivan, a professor of microbiology and immunology at Indiana University, told Live Science: "Necrotising fasciitis can occur anywhere skin or tissue is breached, including genitalia.
"It's an extremely aggressive infection that can advance to a life-threatening situation in 24-48 hours.
"After these bacteria get into the skin, they release potent toxins that lead to rapid tissue destruction, liquefying muscle, nerves, and blood vessels."
It needs to be treated promptly with antibiotics, and sometimes surgery is required to remove damaged tissue.
If the bacteria infect the blood stream, this can subsequently lead to sepsis - a life threatening reaction to an infection where the immune system goes into overdrive, causing the body to attack its own tissues and organs.
Dr Sullivan said: "Vaginal necrotising fasciitis could be contracted through rough sex, a piercing, or cosmetic and surgical procedures.
"The mortality rate is estimated to be up to 50 per cent."
Medics detailed the cases of three women who'd developed the horrifying infection on their vulva - this is the external female genitalia, including the inner and outer labia, clitoris and vaginal opening.
"Two of our patients presented to emergency with vulval necrotising fasciitis, while the third developed it as a complication of postoperative wound infection," they wrote.
"All patients underwent extensive surgical debridement and required a multidisciplinary approach from gynaecologists, surgeons, the intensive care team and the tissue viability team."
The first woman noticed a small spot in her pubic area, for which she was prescribed antibiotics by her GP.
But the spot got steadily more infected over the following five days and flesh eating bacteria spread across her labia majora, left hip and lower abdomen.
Necrotising fasciitis, also called the "flesh-eating disease", is a rare and life-threatening infection.
It can happen when bacteria enters the body through an open wound, like a cut or burn.
The infection spreads quickly and aggressively, causes tissue death and can be deadly if not treated right away.
The signs and symptoms to know:
Symptoms of necrotising fasciitis can develop quickly within hours or over a few days.
At first, you may have:
- Intense pain or loss of feeling near to a cut or wound – the pain may seem much worse than you would usually expect from a cut or wound
- Swelling of the skin around the affected area
- Flu-like symptoms, such as a high temperature, headache and tiredness
Later symptoms can include:
- Being sick (vomiting) and diarrhoea
- Confusion
- Black, purple or grey blotches and blisters on the skin (these may be less obvious on black or brown skin)
Typical treatment:
Necrotising fasciitis gets worse very quickly and can kill.
This is why it must be treated in hospital as soon as possible.
Sufferers will usually be given antibiotics to fight off the infection or in some cases, surgery to remove the affected area
Even after successful treatment, there may be long-term changes in how the body looks. Some people require further surgery and physiotherapy to help recover.
The patient was rushed to A&E, where the infected tissue was surgically removed, or "debrided".
But despite medics' best efforts, she died from sepsis only 28 hours after diagnosis.
The second woman visited the hospital after noticing a lump on her labia a week earlier.
It turned out to be an infected abscess.
The patient ultimately needed three debridements to control the infection, followed by reconstructive surgery, as the necrotising fasciitis broke down the upper third of her labia majora in a matter of 12 hours.
"The wound has since healed well," her doctors noted.
The final patient who case was described in the report was struck by the horrifying infection after undergoing a hysterectomy in order to treat fibroids.
She was treated with antibiotics and had infected tissue surgically removed.
The case report authors said many gynaecologists might not be aware of necrotising fasciitis and urged them to read up on signs of a flesh eating infection as "time is of the essence" when treating it.
"With our review of three cases, we aim to raise awareness of this condition among gynaecologists, who have limited familiarity with it," the paper said.
"Vaginal necrotising fasciitis could be considered more dangerous in the sense that it might be more difficult to diagnose in time, " Dr Sullivan said.
"Gynaecologists may not have it on their diagnostic radar, and surgical interventions, which are usually required to stop NF from spreading and remove dead tissue, may be limited."
It's estimated that around 500 people in the UK develop necrotising fasciitis in the UK every year, according to a BMJ report from 2021.
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