‘Flesh-Eating’ Infections of the Vulva Are on the Rise, Doctors Warn

A rare but horrific kind of infection might be on the rise. Gynecologists in the UK have begun to see an alarming increase in people with necrotizing fasciitis of the vulva, a.k.a. the “flesh-eating” disease.

Doctors at the Shrewsbury and Telford Hospital NHS Trust detailed three such cases in a paper published this month in BMJ Case Reports. All three women were hospitalized, and one died as a result. These cases are part of a growing trend in the UK, the doctors say, and infections that can cause necrotizing fasciitis are increasing in the U.S. as well.

Necrotizing fasciitis is a serious type of bacterial infection that destroys the soft tissues underneath our skin (particularly fascia, hence the name). While the appearance of this infection might resemble freshly-chewed flesh, the bacteria aren’t actually eating it away. Once this destruction starts, it can rapidly spread and trigger other life-threatening complications like sepsis. People can die from necrotizing fasciitis in as little as 12 hours after symptoms begin.

Though there are several different species of bacteria that can potentially cause necrotizing fasciitis, it remains a rare occurrence overall. But the report authors say they’ve noticed a significant uptick lately in cases involving the vulva (the external parts of the female genitalia) at their hospital, which includes the three described in their paper.

In two of the cases, the women were diagnosed with vulvar necrotizing fasciitis in the emergency room. In the third, the woman developed it as a complication from an infected surgical wound.

One woman had seen a doctor five days earlier after noticing a spot on her mons pubis, and was prescribed antibiotics. But the treatment failed to clear the infection, and by the time she was hospitalized, the infection had spread throughout her labia majora, lower abdomen, and left hip. Despite surgical removal of her infected and necrotic tissue (also known as debridement) and intensive care support, the woman died of sepsis just 28 hours after her diagnosis.

The other two women survived their ordeal, though not without serious difficulty. Both needed “extensive surgical debridement” and one woman underwent three separate surgeries to remove tissue, which later required reconstructive surgery.

These cases are only part of a worrying pattern that the doctors have noticed. They identified 20 cases treated at their hospital between 2022 and 2024, compared to 18 reported in the entire previous decade. And they’re not the only ones spotting an overall rise in “flesh-eating” infections.

Last week, for instance, a study from researchers at the Centers for Disease Control and Prevention found that the rate of invasive group A Streptococcus (GAS) infections—the most common cause of necrotizing fasciitis—had more than doubled in the U.S. between 2013 and 2022. Several countries in Europe, including the UK, have also reported a recent increase in GAS infections.

Though necrotizing fasciitis remains rare in general, the doctors hope their report can help alert other ob-gyns to the possibility of these cases, particularly since speedy medical care is needed to prevent death. “With our review of three cases, we aim to raise awareness of this condition among gynecologists, who have limited familiarity with it,” they wrote.

These infections can be fatal anywhere they start, but vulvar necrotizing fasciitis is especially deadly, with a mortality rate as high as 50% without timely treatment.