Flesh-eating germ rare, especially for the healthy
Aimee Copeland, a Georgia grad student, is fighting for her life because of the flesh-eating bacteria that infected her after she gashed her leg in a river two weeks ago. One of her legs was amputated and her fingers will be too, her father says, because of the spreading infection.
She has a rare condition, called necrotizing fasciitis, in which marauding bacteria run rampant through tissue. Affected areas sometimes have to be surgically removed to save the patient’s life.
HOW OFTEN DO PEOPLE GET THESE INFECTIONS?
The government estimates roughly 750 flesh-eating bacteria cases occur each year, usually caused by a type of strep germ.
However, Aimee Copeland’s infection was caused by another type of bacteria, Aeromonas hydrophila. Those cases are even rarer. One expert knew of only a few reported over the past few decades.
DO MOST PEOPLE SURVIVE?
Yes, but about 1 in 5 people with the most common kind of flesh-eating strep bacteria die. There are few statistics on Aeromonas-caused cases like Copeland’s.
Necrotizing fasciitis (flesh-eating disease) facts
- Necrotizing fasciitis refers to a rapidly spreading infection, usually located in fascial planes of connective tissue that results in tissue death (necrosis).
- Different types of bacterial infection can cause necrotizing fasciitis.
- The majority of cases begin with an existing infection, most frequently on an extremity or in a wound.
- Necrotizing fasciitis is a serious condition that is often associated with sepsis and widespread organ failure.
- Treatment involves antibiotics and surgical debridement of the wound areas as well as supportive measures such as insertion of a breathing tube, intravenous administration of fluids, and drugs to support the cardiovascular system.
HOW DOES SOMETHING LIKE THIS HAPPEN?
The germs that can cause flesh-eating disease are common in warm and brackish waters like ponds, lakes and streams. They are not a threat to most people. An infectious disease expert at Vanderbilt University, Dr. William Schaffner, said: “I could dive in that same stream, in the same place, and if I don’t injure myself I’m going to be perfectly fine. It’s not going to get on the surface of my skin and burrow in. It doesn’t do that.”
But a cut or gash - especially a deep one - opens the door for flesh-eating bacteria.
IS THERE ANYTHING YOU CAN DO TO AVOID SUCH AN INFECTION?
Prompt and thorough medical care should stop the infection before it spreads. A wound can look clean, but if it’s sutured or stapled up too soon it can create the kind of oxygen-deprived environment that helps these bacteria multiply and spread internally. Once established, these rare infections can be tricky to diagnose and treat.
What is necrotizing fasciitis?
Necrotizing fasciitis is a term that describes a disease condition of rapidly spreading infection, usually located in fascial planes of connective tissue that results in tissue necrosis (dead and damaged tissue). Fascial planes are bands of connective tissue that surround muscles, nerves, and blood vessels. Fascial planes can bind structures together as well as allow body structures to slide over each other effectively. The disease occurs infrequently, but it can occur in almost any area of the body. Although many cases have been caused by group A beta-hemolytic streptococci (Streptococcus pyogenes), most investigators now agree that many different bacterial genera and species, either alone or together (polymicrobial), can cause this disease. Occasionally, mycotic (fungal) species cause necrotizing fasciitis.
Historically, several people first described this condition in the 1840s to 1870s, and Dr. B. Wilson first termed the condition necrotizing fasciitis in 1952. It is likely that the disease had been occurring for many centuries before it was first described in the 1800s. Currently, there are many names that have been used loosely to mean the same disease as necrotizing fasciitis: flesh-eating bacterial infection or disease; suppurative fasciitis; dermal, Meleney, hospital, or Fournier’s gangrene; and necrotizing cellulitis. Body regions frequently have the term necrotizing placed before them to describe the initial localization of necrotizing fasciitis (for example, necrotizing colitis, necrotizing arteriolitis), but they all refer to the same disease process in the tissue. Important in understanding necrotizing fasciitis is the fact that whatever the infecting organism(s), once it reaches and grows in connective tissue, the spread of the infection can be so fast (investigators suggest some organisms can progress about 3 centimeters per hour) that the infection becomes difficult to stop with both antimicrobial drugs and surgery.
Also, Aeromonas is resistant to some common antibiotics that work against strep and other infections, so it’s important that doctors use the best medicines.
ARE SOME PEOPLE MORE AT RISK?
Yes, people with weakened immune systems are. Copeland’s family has not said whether she had some type of medical condition that could have made her more vulnerable and relatives could not be reached for comment Monday. Her doctors, meanwhile, have refused interviews.
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By MIKE STOBBE | Associated Press