The affected area may spread rapidly. Gram-negative bacterial organisms are usually implicated. The affected area should be cleaned regularly with povidone iodine solution, necrotic tissue gently removed, and the terrapin isolated immediately. Most cases result from localized traumatic injury, e.g., burns from heaters or abrasions from sharp rocks in the tank etc. Lethargy, weakness, possible red flush to limbs or plastron.
Many cases result from traumatic injury, especially if incurred in contaminated water.
There may be hepatosis as the liver can rapidly become implicated. Urgent parenteral antibiotic treatment is required together with careful and intensive supportive therapy. Blood tests can be useful in establishing the progress of treatment. The legs may be weak and the terrapin may have trouble feeding. Very severe cases are unlikely to survive.