Joseph Jones: infection with flesh eating bacteria

Abstract

A Confederate Army surgeon, Joseph Jones, is generally credited to have provided the first modern description of necrotizing fasciitis, then known as hospital gangrene. This is a soft tissue infection characterized by a rapid and progressive course. In the 1990s, this entity has been popularized by the media as representing infection with "flesh eating bacteria." Certain patients are at particular risk to develop necrotizing soft tissue infections. Those with impaired immunity, diabetes mellitus, and intravenous drug abuse are particularly vulnerable, but these infections can also occur in previously healthy patients. Diagnostic radiographic testing is often helpful, including the use of plain radiographs, computed tomographic (CT) scan and magnetic resonance imaging (MRI). The most frequent infecting bacterial organism is Group A beta-hemolytic streptococcus, and there are indications to suggest that this organism may be acquiring greater virulence. Many infections, however, involve several bacterial pathogens. The keys to successful outcome are early diagnosis and surgical debridement. Fluid resuscitation and administration of broad spectrum antibiotics should be initiated as soon as the diagnosis is suspected.