Doctors warn of rise in terrifying flesh-eating genital disease - and grooming mistake could be to blame

Daily Mail​

22-04-2025

British gynaecologists have been warned of a startling rise in cases of a deadly flesh-eating disease that affects patients' genitals.
Medically known as necrotising fasciitis, doctors from Shrewsbury and Telford Hospital NHS Trust said they had seen 20 confirmed incidences over the last two years - compared to 18 over the previous decade.
While the cause of the spike was unknown, the medics said it could be a due to a rise in bacterial infections or from lowered immunity due to the Covid lockdown.
To demonstrate the dangers, they highlighted three cases whereby women had contracted the flesh-eating disease in their vulva, the external parts of female genitalia.
In one case recorded by the report authors, the woman died mere hours after being admitted.
Experts in the field have suggested the disease could be caused by injuries that result from shaving the intimate area, or even rough sex.
Necrotising fasciitis occurs when bacteria enters an existing wound and infiltrates the deeper layers of the skin.
Once there the bacteria begin to multiply and spread rapidly over mere hours.
As they do so they release toxins that destroy tissue, giving the condition its 'flesh-eating' nickname.
The authors, who published their report in the journal BMJ Case Reports, said they wanted to raise awareness of necrotising fasciitis in the genital region.
'This case series aims to raise awareness of this life-threatening condition among gynaecologists and hence prevent delay in diagnosis and treatment crucial to avoid poor patient outcomes,' they wrote.
The first patient detailed — the most serious of the three — noticed she had developed a small spot on her mons pubis the area of fatty tissue located just above the genitals.
At first, she waited to see if it would resolve on its own but later sought help from her GP who — suspecting it was skin infection — gave her a basic course of antibiotics.
However, the spot and her health deteriorated over the next five days.
WHAT IS NECROTISING FASCIITIS?
Necrotising fasciitis is most commonly caused by an infection with group A Streptococcus.
Those infections normally last just a few days - they are mild and typically clear themselves up.
But in some unusual cases it can develop into necrotising fasciitis.
They infect flat layers of a membrane known as the fascia, which are connective bands of tissue that surround muscles, nerves, fat, and blood vessels.
The infection also damages the tissues next to the fascia.
Sometimes toxins made by these bacteria destroy the tissue they infect, causing it to die.
When this happens, the infection is very serious and can result in loss of limbs or death.
After seeking help at A&E it was discovered necrotising fasciitis had taken hold, spreading from the spot to her outer labia, as well as her through her lower abdomen in general.
Despite medics rushing to cut away the dead tissue the patient died from sepsis, an immune system reaction to an infection, just 28 hours after being diagnosed.
The second patient sought emergency help with a 3cm lump in her vulval region that turned out be abscess a build-up of pus from an infection.
Medics noted that over the next 12 hours the upper third of the patient's outer labia 'broke down' due to the flesh-eating disease.
She would end up needing three operations to remove the dead tissue as well as reconstructive surgery to restore the look of her genitalia.
The last patient, in contrast to the other cases, suffered necrotising fasciitis in her vulval region after a scheduled hysterectomy — a procedure that removes the womb.
This patient came back to hospital complaining of discomfort at the operation site and a fever.
Investigations then found dead tissue and she was rushed for an operation to cut this away.
She survived but medics noted that she had been left in significant pain and discomfort from this operation, and she was currently waiting for follow-up care.
Professor Bill Sullivan, an expert in microbiology and immunology at Indiana University, who was not involved in the case report, said necrotising fasciitis can occur anywhere in the body which suffers a wound.
He said cases in the female genital region had numerous potentially be causes.
'Vaginal necrotising fasciitis could be contracted through rough sex, a piercing, or cosmetic and surgical procedures,' he told Live Science.
Other nicks and scrapes, for example via personal grooming, are another potential trigger.
In 2017 one woman reported how she almost lost her legs to necrotising fasciitis after cutting a spot on her groin while shaving her bikini line.
Professor Sullivan added that he agreed with the report authors' call for gynaecologists to be more aware of flesh-eating disease in this area.
'Vaginal necrotising fasciitis could be considered more dangerous in the sense that it might be more difficult to diagnose in time,' he said.
'Gynaecologists may not have necrotising fasciitis on their diagnostic radar, and surgical interventions, which are usually required to stop necrotising fasciitis from spreading and remove dead tissue, may be limited.'
Necrotising fasciitis, of any form is rare in the UK with only an estimated 500 cases recorded each year.
Outcomes for patients mostly depend on how quickly the condition is diagnosed and prompt access to surgery and antibiotics.
Sometimes patients may need to have entire limbs amputated to save their lives.
Previous studies in the US have found only about half of patients who contract vulval necrotising fasciitis survive.
Initial signs of necrotising fasciitis include intense pain or numbness around a cut or wound, swelling in the affected area, and flu like symptoms like a fever and fatigue.
This later develops to vomiting and diarrhoea, mental confusion and black, purple or grey blotches or blisters emerging on the skin.
Necrotising fasciitis is a medical emergency and anyone with these symptoms is advised by the NHS to call 999 or be taken to A&E.