Digital illustration of necrotizing fasciitis affecting the abdomen due to diverticulitis, highlighting bacterial infection and tissue damage.

The Silent Threat: Understanding Necrotizing Fasciitis from Diverticulitis

Theo Raines in Health & Wellness June 2025 • 4 min read.

"Unveiling the connection between a common digestive issue and a rare, flesh-eating bacterial infection."

Diverticulitis, a common condition affecting the digestive system, often presents with abdominal pain and changes in bowel habits. While many cases are mild and resolve with simple treatments, some can lead to serious complications. One of the most alarming of these is necrotizing fasciitis, a rapidly progressing bacterial infection that destroys soft tissues, including muscle and fat. This article delves into the rare but critical link between sigmoid diverticulitis and necrotizing fasciitis, providing essential information on recognizing, preventing, and addressing this life-threatening condition.

Necrotizing fasciitis, often dubbed the "flesh-eating disease," is a severe infection characterized by rapid tissue destruction. It typically enters the body through a break in the skin, such as a cut or surgical wound, but can also arise from internal infections. Bacteria release toxins that damage nearby tissues, leading to inflammation, swelling, and eventual necrosis (tissue death). Early diagnosis and treatment are crucial, as the infection can spread quickly and become life-threatening within hours.

The connection between sigmoid diverticulitis and necrotizing fasciitis, though rare, highlights the importance of understanding the potential complications of seemingly common conditions. Sigmoid diverticulitis occurs when small pouches (diverticula) in the lining of the large intestine become inflamed or infected. In some cases, this inflammation can lead to perforation (a hole) in the intestinal wall, allowing bacteria to leak into the surrounding tissues. If these bacteria are particularly virulent, they can trigger necrotizing fasciitis.

How Does Diverticulitis Lead to Flesh-Eating Bacteria?

Digital illustration of necrotizing fasciitis affecting the abdomen due to diverticulitis, highlighting bacterial infection and tissue damage.

The sequence of events leading from sigmoid diverticulitis to necrotizing fasciitis typically involves a perforation or leakage in the colon. Here's a breakdown:

The role of bacteria in this process cannot be overstated. Certain types of bacteria are more likely to cause necrotizing fasciitis than others. These bacteria often produce enzymes and toxins that break down tissue, allowing the infection to spread rapidly. Common culprits include:

Streptococcus species (Group A Strep)
Staphylococcus aureus
Clostridium perfringens
Escherichia coli (E. coli)
Klebsiella
Aeromonas hydrophila

Once bacteria have breached the intestinal wall and entered the surrounding tissues, they can quickly spread along the fascial planes (connective tissue layers) beneath the skin. This rapid spread is what gives necrotizing fasciitis its destructive nature. The infection causes inflammation, tissue death, and the release of more toxins, creating a vicious cycle that can be difficult to control.

The Takeaway

While the connection between sigmoid diverticulitis and necrotizing fasciitis is rare, it underscores the importance of recognizing potential complications of even common conditions. By understanding the risks, symptoms, and preventive measures, individuals can take proactive steps to protect their health. If you experience severe abdominal pain, fever, and rapidly spreading skin infection, seek immediate medical attention. Early diagnosis and treatment are crucial in combating necrotizing fasciitis and improving outcomes.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.cireng.2018.07.001, Alternate LINK

Title: Thigh Necrotizing Fasciitis Secondary To Perforated Sigmoid Diverticulitis

Subject: General Medicine

Journal: Cirugía Española (English Edition)

Publisher: Elsevier BV

Authors: Jorge Sancho Muriel, Matteo Frasson, Salvador Pous, Eduardo García-Granero

Published: 2018-08-01

Everything You Need To Know

What is diverticulitis?

Diverticulitis is a common digestive issue marked by inflammation or infection of small pouches (diverticula) in the lining of the large intestine, often leading to abdominal pain and changes in bowel habits. Although many cases are mild, serious complications can arise. These pouches form in the colon wall, and when they become inflamed or infected, it's termed diverticulitis. It's significant because it can sometimes lead to the serious complication of necrotizing fasciitis.

What is necrotizing fasciitis?

Necrotizing fasciitis, often known as the "flesh-eating disease," is a severe bacterial infection characterized by rapid tissue destruction. It typically enters the body through a break in the skin, but it can also arise from internal infections. The bacteria release toxins that damage the tissue, leading to inflammation, swelling, and eventually necrosis (tissue death). Early diagnosis and treatment are crucial, as it can spread quickly and become life-threatening. It is a severe complication that can arise from sigmoid diverticulitis.

How does diverticulitis lead to necrotizing fasciitis?

The link between sigmoid diverticulitis and necrotizing fasciitis lies in how diverticulitis can compromise the intestinal wall. With diverticulitis, if the pouches in the large intestine become inflamed or infected, this can lead to a perforation (a hole) in the intestinal wall. This then allows bacteria to leak into the surrounding tissues. If those bacteria are virulent enough, they can trigger necrotizing fasciitis. The bacteria then spread along the fascial planes, causing rapid tissue destruction. This is a rare but serious complication, highlighting the importance of understanding the risks associated with common conditions like sigmoid diverticulitis.

What types of bacteria cause necrotizing fasciitis?

Several types of bacteria can cause necrotizing fasciitis. Common culprits include Streptococcus species (Group A Strep), Staphylococcus aureus, Clostridium perfringens, Escherichia coli (E. coli), Klebsiella, and Aeromonas hydrophila. These bacteria release enzymes and toxins that break down tissue, which then allows the infection to spread rapidly. The specific bacteria involved can affect the severity and progression of the infection. Identifying the specific bacteria is important for effective treatment.

What are the key things to know about preventing and treating this condition?

If you experience symptoms such as severe abdominal pain, fever, and a rapidly spreading skin infection, seek immediate medical attention. Early diagnosis and treatment are crucial in combating necrotizing fasciitis. This typically involves a combination of antibiotics, surgical removal of infected tissue, and supportive care. Prevention involves managing conditions like sigmoid diverticulitis, which can involve dietary changes, antibiotics, and sometimes surgery, to reduce the risk of complications like necrotizing fasciitis.