What’s Eating You?

by NotDownOrOut

Have you noticed how many stories there are in the news about people suffering from or dying from a flesh-eating infection? https://www.cbsnews.com/news/flesh-eating-bacteria-florida-womans-death-gulf-vaction-necrotizing-fasciitis-shines-light-on-rare-infection/.  Some of the news stories published in the last month have included speculation that we may see more cases as a result of climate change.  https://www.businessinsider.com/flesh-eating-bacteria-spreading-due-to-warmer-oceans-2019-6. The theory is that many are experiencing infection when they suffer a scratch or cut and are shortly thereafter using a pool, hot tub, or, even more commonly, a body of water like a lake or the ocean. In some cases, the news stories identify the form of infection suffered as Vibrio vulnificus. That infection is associated with warm, salty or brackish water. The infection enters the body through a cut or when one eats raw shellfish.

So far, the evidence of an increasing number of cases seems anecdotal. Take for example, this statement in an article by Business Insider:

“In 2017, we saw three cases of severe skin infections, which raised some flags,” Dr. Katherine Doktor, an infectious disease specialist at Cooper University Hospital who co-wrote the report, told Business Insider. “In 2018, we saw two more. These five cases are significant because in the eight years prior to 2017, we only saw one case of Vibrio vulnificus at our institution.”

https://www.businessinsider.com/flesh-eating-bacteria-spreading-due-to-warmer-oceans-2019-6.

When I experienced a flesh-eating infection in 2017 it had nothing to do with water or shellfish. My infectious disease doctor said that most of us have staph, strep, Klebsiella, Clostridium, or, more rarely,  E. Coli on our bodies at some time.  https://jcm.asm.org/content/50/12/4008; https://www.livescience.com/63203-flesh-eating-bacteria-cut.html; https://www.healthlinkbc.ca/healthlinkbc-files/flesh-eating-disease. If these infectious bacteria find an open cut or wound, even a small one, the average individual’s resistance will fight off the infection. But, whether it is the vibrio or another infection that finds an entry, if the individual’s resistance is lowered by some weakening of the immune system, then the infection can take off. At the time, I was unaware that I had become diabetic. I was several years past treatment for endometrial cancer and the point at which infection began was in an area that had been treated with radiation. My doctor said either of those conditions might have made me more vulnerable. Kidney or liver disease, alcoholism, HIV, and, in some cases, chicken pox, can weaken immunity. https://www.cdc.gov/groupastrep/diseases-public/necrotizing-fasciitis.html; https://labtestsonline.org/news/flesh-eating-bacterial-infections-are-rare-can-be-life-threatening. Some sources provide even more extensive lists of vulnerabilities. https://rarediseases.org/rare-diseases/necrotizing-fasciitis/.

The important takeaway from recent cases is  the need for swift action. In my case, I had a tiny red dot on my abdomen that hurt disproportionately to its appearance. I developed a fever. I made an appointment to see a doctor and waited several critical days for that appointment before the pain was so severe I went to the emergency room. The intern who first examined me was not thinking of a flesh-eating infection. While she continued her work-up, she speculated that, due to the lack of readily apparent cause for my pain I might be sent home with an antibiotic to “let things fester.” Had that been her final decision, I would most certainly have died. My infectious disease doctor said that I was within an hour of the point of no return when I showed up at the hospital.

The attending physician came in to examine me and started me on a course of intravenous antibiotics. By the time I left the hospital two weeks later, I had been given a large number of different antibiotics. I had flesh surgically removed all across the abdomen. I was lucky. Some sources say 600-1200 people will get such an infection each year. One in three or four who get such an infection die. https://www.webmd.com/skin-problems-and-treatments/necrotizing-fasciitis-flesh-eating-bacteria#1; https://labtestsonline.org/news/flesh-eating-bacterial-infections-are-rare-can-be-life-threatening. Many will lose a limb or a body organ before treatment concludes.https://www.livescience.com/63203-flesh-eating-bacteria-cut.html .

I had several surgeries to remove the infected flesh. The infection can consume skin, muscle, nerves, blood vessels, and fat. My doctor found my infection had multiple bacterial causes. Some doctors speculate group A strep is most commonly the instigator. https://www.cdc.gov/groupastrep/diseases-public/necrotizing-fasciitis.html.

If you are in a vulnerable category, then take care to wash and disinfect any wounds or punctures. Keep wounds clean and bandaged. Avoid exposure to ocean, lake or other waters while you have an open wound, use hand sanitizers, and see a doctor immediately if pain or redness or flu-like symptoms occur.