The phrase “flesh-eating” is nightmarish enough to stop anyone dead in their tracks, conjuring up images of flesh falling off of the bone, deep black necrosis, or perhaps a zombie apocalypse in which the undead are biting flesh from bone. Be it flesh-eating zombies, flesh-eating animals, or, even more terrifying, flesh-eating microscopic organisms, the idea of being eaten alive is downright terrifying, and when it comes to the latter, it’s more frightening to think of something you can’t see that slowly eats away at you.

The world of pathogens is a strange world indeed, and there are some pretty nasty critters out there that would love nothing more than to take a bite out of your flesh—and sometimes bone. Some pathogens hijack the minds of their human hosts, controlling their behavior, their thought patterns, and even their actions. Others lodge themselves inside you and consume you from the inside out. Here are ten nightmarish flesh-eating pathogens and their destructive ways.

10 Necrotizing Fasciitis

Necrotizing fasciitis deserves an honorable mention here at the top of the list, as it’s the result of several infections on this list. Necrotizing fasciitis is caused by the presence of pathogens which cause the skin to rot, especially when they become entrenched into the inner layers of the flesh. If it isn’t treated right away, necrotizing fasciitis can kill you, with anywhere from 25 to 30 percent of the cases being fatal.

Necrotizing fasciitis has earned the moniker “flesh-eating disease,” which is quite the terrifying name. While the infections that cause it vary, the pathogens don’t literally eat the flesh but rather excrete toxins that destroy tissue, causing the condition.^[1] Drug and alcohol users as well as diabetics and those who are immunocompromised are particularly at risk for necrotizing fasciitis.

9 Vibrio Vulnificus

Vibrio vulnificus is often found in a place that’s a perfect climate for the bacterium to grow and also possesses the large bodies of water which it likes to flourish in: Florida. A person can become infected either by going into the water with an open cut or wound or consuming undercooked or uncooked seafood, as it lives and thrives in salt water. Vibriosis, the disease spawned from the Vibrio genus of bacteria, can be fatal. It should be noted, as alluded to above, that V. vulnificus causes the flesh to rot rather than eating it, but that difference is quite irrelevant when you see chunks of your arm missing.

Even more terrifying is that V. vulnificus not only attacks the surface flesh but can bury itself and get underneath the top layer of tissue. It can even seep in and cause the internal organs to rot away and even eventually shut down. Sometimes, people lose limbs to the disease.^[2] Again, the immunocompromised are much more likely to contract this flesh-rotting bacterium, as well as people with liver problems. The Centers for Disease Control in the United States suggests not eating raw or undercooked fish if you’re trying not to catch this, and 80 percent of cases come between May and October, when the water is warmer, so these are the best times to avoid the water to avoid the disease.

8 Donovanosis

Donovanosis, also known as granuloma inguinale, is a disease that comes from the bacterium Klebsiella granulomatis. It’s relatively new on the scene, and it may very well be the scariest thing on this list. Why? Because it’s an STD. That’s right, donovanosis is a flesh-eating STD.^[3] The bacteria can destroy the flesh in, around, or on the genitals and can do more damage if they spread to other parts of the body. The damage to the exterior flesh can cause large, red, vascular lesions, and these holes in your flesh bleed.

This disease typically makes its initial home at sites in and around the pelvis but can work its way up inside of you and get into your organs, damaging them, too. If that wasn’t bad enough, in extreme cases, Klebsiella granulomatis can get into your bones as well if not treated promptly. Fortunately, the treatment is rather simple, with broad-spectrum or targeted antibiotics. But imagine waking up one day to find your genitals and the surrounding areas slowly rotting—even if it’s treatable, this is a day that nobody wants to see.

7 Pseudomonas Aeruginosa

Pseudomonas aeruginosa is a bacterium that grows pretty much everywhere and on pretty much everything, though it doesn’t always infect us—instead, it waits for an opportune opening, such as a cut or scrape, and when the conditions are just right, it will seep into the wound and multiply. P. aeruginosa can cause necrotizing fasciitis. The good news is that healthy people generally have a very low risk of becoming infected by this particular bacterium, but as is often the case, those who have immune system deficiencies can experience problems with it.^[4]

If left untreated, Pseudomonas aeruginosa can reach the internal organs and cause death. If left alone, it will eat all the way down to the bone. As with other Pseudomonas species, some of the more severe cases invole infections in the blood or the lungs. What’s really the most terrifying thing about Pseudomonas is the fact that many strains of it have developed antibiotic resistance and are quite difficult to treat, meaning that P. aeruginosa could eat away at you while doctors attempt to find an antibiotic regimen that will work to eliminate the bacteria.

6 Staphylococcus Aureus

Yes, as freaky as it sounds, the common staph infection can become necrotic and flesh-eating. Methicillin-resistant Staphylococcus aureus (MRSA) is Staph aureus with additional antibiotic resistance, making infections rather difficult for modern medicine to treat. Fortunately, not all cases of staph and MRSA turn into flesh-eating necrosis, but doctors can’t actually tell which strains and cases will eventually turn into a condition that eats away at the flesh, so it’s better to treat all situations involving these bacteria as if they were about to become necrotic.^[5]Staph aureus and its antibiotic-resistant counterpart both present with a nasty, thick pus which can get deep into the skin, working its way into muscles and ultimately into the bloodstream—once these infections seep into the blood, a powerful and brutal sickness ensues, and death is a likely possibility. On top of that, if the condition brings about necrotizing fasciitis, you’ll have some serious decay and blackening of the tissue layers as the excreted toxins from the bacteria wreck havoc.

5 Naegleria Fowleri

Naegleria fowleri is an amoeba that severely affects the brain on the rare occasion that it inhabits a human host—these dangerous critters love to hang out and reproduce in fresh water, making them ample under the right climate conditions, though they need to travel up the nose and into the brain in order to “hijack” your mind. How do they do that? By reproducing and spreading quickly and then slowly eating away at your brain, that’s how.

Under certain conditions, the amoeba just forms into a cyst that’s inactive and doesn’t do much of anything, but when conditions become right, they become active and begin to feed. The Centers for Disease Control says about the mechanism of death from this particular amoeba: “The infection destroys brain tissue causing swelling and death.”^[6] This is definitely not a fun pathogen to catch by any stretch of the imagination.

4 Clostridium Perfringens

Clostridium perfringens is another nasty one. It can be found in soil, water, and the human intestinal tract. This bacteria can cause a specific kind of gangrene called gas gangrene, and it definitely does not at all look very fun. The toxins which are excreted by the bacteria travel through veins, blood vessels, and other bodily systems, and they kill off the flesh inside of the body by poisoning it.^[7]

This causes massive distention, huge pockets of bloating gas that come from the bacteria feeding and releasing of gasses inside the body. Massive bulbs of purple and red swelling show up on the outside of the body as the internal gasses protrude and push outward.

3 Streptococcus Pyogenes

Possibly the best-known cause of necrotizing fasciitis is Streptococcus pyogenes, also referred to as “Group A Streptococcus.” This bacterium also causes strep throat, which many people, even in the developed world where antibacterial everything is prevalent, end up catching at one point, often as children. Like the others on this list, Streptococcus pyogenes produces toxic byproducts which cut through tissue layers of fat, muscle, and skin like butter. This infection starts off rather mild, most commonly presenting as a sore throat, but it can progress and eat away at the tissue of the infected and even cause toxic shock syndrome, a condition that comes with headache, nausea, vomiting, and much more and is also definitely no fun to get.

While most cases of strep throat don’t turn into “the flesh-eating disease,” some of them do, and the effects can be both long-term and devastating.^[8] This happens when the body’s immune response isn’t quick or powerful enough to fight off the invasive strep, and the results can be deadly. Yes, the common strep throat can actually eat your flesh until you die.

2 E. Coli

Escherichia coli is a relatively well-known bacterium which is often responsible for the common food poisoning we all miserably endure every so often. This is the usual E. coli infection, and it’s nothing to shake a stick at, but sometimes, E. coli can go above and beyond the usual case of what we know of as “food poisoning” and become catastrophically worse. As with most bacteria, the body’s immune system as well as antibiotics have fought off the invaders for a very long time, causing variations in the strains which possess radically different traits and can have radically different outcomes upon infection. Some strains of E. coli can cause the death and decay of the skin cells also as they slowly eat away at your flesh.

These strains prey upon people with limited or suppressed immune systems, which can’t fight off the infection—all cases in some studies have been fatal. A specific gene called the cnf1 toxin gene is possessed by the flesh-eating variations of E. coli, which causes them to emit a toxin which destroys flesh like an acid. Animal studies have shown that the presence of this gene in the bacteria causes the toxin to be excreted when animals are infected as well. These E. coli strains are the stuff that nightmares are made of.^[9]

1 Mycobacterium Ulcerans

Mycobacterium ulcerans is a bacterium which is the cause of a disease called buruli ulcer, which causes, you guessed it, ulcers to appear within the skin. But much more than this, buruli ulcer is also a flesh-eating condition. Prolonged infection will cause ulcers on the arm and legs typically, and the chunks of flesh which have been eaten away will usually worsen over time. Only ten percent of cases present with flesh-eating ulcers in other parts of the body outside of the limbs, but that’s still a scary ten percent. As the bacteria spread, they produce a toxin called mycolactone, which is responsible for the destruction of flesh in patients who’ve contracted the bacterial infection and allowed it to progress to the disease of buruli ulcer.

Even more terrifying than having this bacterium secrete toxins which eat away at your flesh while you wait helplessly for it to go away, or for your treatments to work, is that beyond just skin, ligament, muscle, and other soft tissues, the disease can eventually spread down to the bone and begin to eat away at that, too.^[10] And what’s even more nightmarish than that? They have no idea how this bacterium spreads. Very little is known about how M. ulcerans transmits from one person to the next, so we don’t really know what any of us can do to avoid becoming its next target—yet. Hopefully someday, science will develop methods to eradicate these bacteria as well as new and unique treatments, but for now, we’re stuck with limited knowledge and treatment options.

I like to write about the dark, strange, macabre, and unusual.

A human can only live for about three days without access to water. We need to drink or we’re doomed. And while our ancient ancestors probably managed just fine with water and the odd squirt of fruit juice, we evolved to enjoy a far more diverse palate. You might even say we’re spoiled for choice when it comes to beverages these days. For evidence, just take a look at all the drinks people will consume on purpose… amazingly, without even being forced to do so. 

10. End of History

The average alcohol percentage in a beer that you’ll find in the United States is about 4.5%. There are some stronger beers out there, but that is pretty standard. The Scottish Brewery known as Brewdog came up with a beer called the End of History that boasts a 55% alcohol content. And interestingly enough, that’s not why it’s interesting. The beer is actually packaged inside squirrels.

Each bottle of limited run beer was inside of a taxidermied squirrel. The company initially released 12 in the UK, and then 10 more bottles were released for Americans.The price per bottle in the United States was $20,000. Technically that wasn’t the price of the beer itself; rather, if you invested $20,000 in their business you would get one of the 10 extremely rare bottles.

9. Pruno

They say that necessity is the mother of invention and that idea was clearly hard at work when pruno was invented. Pruno, otherwise known as prison wine, is what you get when you’re desperate for a buzz but your ingredients and facilities are extremely limited.

Since all that is really needed to create alcohol is some kind of sugary base that can ferment, prisoners were able to develop ways to create alcohol behind bars in secret. The resulting concoction is known as pruno, and it’s one of the most vile drinks ever created.

Ingredients are very limited in prison, which means pruno is often made of things like fruit cocktail, sugar cubes, and ketchup. Everything is mixed together in a ziplock bag and hidden where the prison guards can’t find it. The fermentation process could take a few weeks and you’ll have to find some way to warm your mixture up, strain out all the chunks, and then enjoy the potentially lethal byproducts. The resulting mixture can contain all manner of dangerous bacteria including botulism, not to mention there’s no way to know just how alcoholic the brew might be so it could be dangerously potent as well.

8. Sourtoe Cocktail

If you’re going to list culinary taboos, you can jump right to the head of the line by mentioning cannibalism. There are few things people are willing to  entertain less than the idea of consuming the body parts of another human being. And yet despite that, the sourtoe cocktail is still a thing.

Arguably the most infamous drink in all of Canada, you can find the sourtoe cocktail in Dawson City, Yukon. The name isn’t particularly metaphorical. There’s a real human toe in a shot of whiskey that you can drink.

According to legend, Louie and Otto Linken were running booze back in the 1920s when they got caught in a blizzard. Louie ended up getting his foot stuck in a stream or a puddle when he stepped through some ice and by the time he got home again his foot was frozen. Worst of all was the big toe, which had thoroughly succumbed to frostbite.

In an effort to prevent any more damage, Otto cut his brother’s toe off with an axe. And, as one does, he dropped the newly severed digit into a bottle of booze. Fast forward about 50 years and a man by the name of Captain Dick Stevenson found the bottle, complete with toe, in a cabin.

Stevenson decided to create a little contest where you could gain entry into the Sourtoe Cocktail Club if you had the drink with the toe in it. The only rule is that the toe had to touch your lips. And word is that about 100,000 people have actually done this over the years. 

In the year 2013, one guy actually swallowed the toe. And he wasn’t even the first one. The Downtown Hotel, where the drink is served, has gone through 15 toes so far. Captain Stevenson even willed his own toes to the hotel so that when he dies the tradition will live on. Currently, the bar has 12 toes that they rotate through circulation so they can keep them clean, whatever that might mean.

7. Spirytus Stawski 

Straight out of Poland comes Spirytus Stawski, a 190-proof spirit that is 96% alcohol. That makes it the single strongest drinkable alcohol in the world. To put that in perspective, vodka is generally around 40% alcohol. Rubbing alcohol is often 70% alcohol. Even the infamous Everclear is 95% alcohol. Spirytus Stawski one-upped them with that extra percentage to ensure maximum danger.

You can buy Spirytus Stawski any number of places online, but most of them will point out in the description that this should only be used as a base for other drinks and it is highly recommended that you never drink the stuff straight, for obvious reasons. A 750ml bottle will set you back under $20.

6. Chicha

If you ever have the opportunity to visit Peru you may run across a drink known as chicha. Chicha is made from corn, and so far everything sounds okay. You can make whiskey from corn. Bourbon has a long history thanks to corn. You can even brew vodka from corn rather than potatoes, if you’re so inclined. So far so good, right?

Where chicha gets a little weird is in the preparation. If you are drinking true, traditional chicha then the fermentation process requires that the corn be chewed and then spit out. The old-timey method for making it involved several women sitting around a bucket, chewing up the corn, and then spitting it into that bucket. The saliva, along with a few other ingredients, would activate the fermentation process and eventually it would become alcoholic. There’s no real way to make that sound any better that it is, and it’s definitely an acquired taste. Weirdly enough, it’s still made this way in some parts of Peru and if you buy it from a street vendor you may not know if you’re getting the traditional kind, or a less saliva-filled brew.

5. Baby Mice Wine

In most parts of the world if you were to find a mouse in your drink you would probably have a well-justified freak out and send the drink right back. Well, that wouldn’t be the case if you ordered what’s been called a traditional Chinese health tonic that is colloquially known as baby mice wine.

Apparently these little mice are taken just after birth when their eyes aren’t even open yet and then jammed into a bottle of rice wine. They ferment along with the wine for a solid year, after which time it is said that the brew is able to treat medical conditions like liver disease and asthma. It also apparently tastes something like gasoline, which doesn’t seem unreasonable since it’s just rice wine with the rotting corpses of vermin inside of it. And yes, if you’re wondering, you are expected to actually eat the little mice afterward as well.

4. Kumis

Theoretically, drinking milk is kind of weird if you stop to give it much thought, at least if you’re drinking the milk of a cow or some other kind of livestock. (Really, though… who was the first person to look at a cow’s udder and think, “I’m gonna go suck on that”?)

But, since we have been doing it for centuries and it’s pretty commonplace, we’re used to it. The dairy industry is massive and even if you’re not drinking milk, there’s a good chance you’re enjoying things like butter, yogurt, or ice cream. All of that stuff tends to have one thing in common, in that it’s made from purified, non-alcoholic milk.

If you were to travel around the globe to Kazakhstan you would find a beverage known as kumis, which is made from the milk of horses. Now to a western palate the idea of horse milk probably sounds a little bit weird, but it really shouldn’t if we are okay with drinking milk from cows. However, kumis takes it one step further by fermenting the milk to make it alcoholic. According to reviews it tastes like champagne and sour cream mixed together. That’s one heck of a cocktail. 

Kumis has been made for thousands of years in Central Asia and apparently it’s something that both Genghis Khan and babies enjoyed drinking. You know you’re a hardcore baby when you’re drinking alcoholic horse milk on the Central Asian steppes.

The mare’s milk has a high sugar content naturally, so if you churn it the way you would churn butter it will thicken up and acidify to produce an alcoholic kind of carbonation. And as weird as this might sound, it’s actually preferable to drinking non-alcoholic mare’s milk. The milk, in its natural state, has so much lactose that it’s essentially a high-performing laxative.

3. Poop Wine

There’s no good backstory to this entry. There’s no clever reason why this thing exists. There’s just the knowledge that for some reason, at some point in time, someone fermented actual human poop into a drink and then intentionally drank it. That’s the story of poop wine.

Made from Korean rice wine mixed with the feces of a human child, the drink called Ttongsul has 9% alcohol and is 100% terrible. The concoction is apparently for medicinal use and was said to be able to heal traumatic injuries like bruises, cuts, and even broken bones.

Very few people have heard of the drink even in Korea, but there are one or two who still know the recipe and are willing to make it if you are so inclined to hunt it down. It should go without saying that there is no way this drink is good, or even tolerable.

2. Smoker’s Cough Cocktail

A lot of bars are willing to go out of their way to create signature cocktails that nobody else has on the menu. Sometimes these will be simple mixtures that maybe just have a unique name even though they are available in other locations by different names. But sometimes they are just over the top recipes that mix together ingredients that have no business being in the same place at the same time. That’s likely the story behind one of the most repellent looking and tasting cocktails ever made, the Smoker’s Cough.

The name itself is off-putting, and when you take a look at it you understand why it’s called what it’s called. There are only two ingredients in this cocktail making it deceptively simple but the two ingredients that you need are mayonnaise and Jagermeister. Even without tasting that you can try to imagine those two flavors and textures together in your mouth. If the idea was to mimic the sensation of acrid phlegm, then the person who created the cocktail is actually fairly clever and did a good job.

1. Semen Cocktails

This unsettling entry brings with it an entire recipe book.  The number of people on Amazon.com who reviewed the book and described it as a gag gift may or may not be aware of the added pun in their language choice. Regardless, there is apparently some kind of market out there for drinks that are made with semen. Some of the less than impressed reviews pointed out that most of the recipes in the book are just average everyday cocktails with the secret ingredient added in for no particular reason.

While this truly sounds like a gimmick if nothing else, it’s worth knowing that New Zealand is home to the Green Man Pub in the city of Wellington. Their claim to fame is a beer that  was created from stag semen. Why did this concoction even exist? Probably just to get some press for creating something utterly baffling.