It is also known as flesh eating disease, it is a polymicrobial disease mostly by E.coli, bacteroides, staphylococcus, streptococcus, or clostridia. 80% of the cases have history of previous trauma, or infection (60% reported as lower extremities infection). Predisposing factors are diabetes, pressur sores, perineal infection which manifests as fournier's gangrene. Clinical features are edema, rash, erythema, crepitus, pain out of the proportion to the condition, and rapid progression to septic shock and toxemia. Remember that the skin manifestation appear late. Treatment is by fluid resuscitation, antibiotics, and dressing like VAC or skin graft.