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Thursday, May 31, 2012

Flesh-Eating Bacteria: Myths and Facts

By Roy Benaroch, MD

Wound

It’s all over the news: a healthy young woman in Georgia has been attacked by “Flesh Eating Bacteria.” Thankfully, she’s finally off of a ventilator. She’s still critically ill, even after undergoing several heroic surgical procedures to remove dead tissue. There will be a lot of rehab in her future, and she will never be the same.

The recent media frenzy over this case has helped create and perpetuate some myths about this very serious, though uncommon infection:

There is an epidemic. Necrotizing fasciitis is uncommon, but not that rare, affecting about 10-15,000 people in the United States annually. The rate is not increasing.

It mostly affects healthy people. Though the current media-favorite case is a healthy young woman, necrotizing fasciitis is more common in people with underlying health problems like diabetes or poor immunity.

The bacteria eats your flesh. It’s a vivid, horrifying image: being eaten alive by tiny monsters. The truth is that tissue is destroyed by toxins released by the bacteria, along with the victims’ own immune response. There is no eating involved.

Necrotizing fasciitis is caused by a bacterial infection under the skin, often involving multiple kinds of bacteria. The infection spreads rapidly and triggers a massive immune response that itself can make matters worse, leading to problems with other organ systems. Treatment involves not only high-potency antibiotics, but often multiple surgeries and high-tech intensive care to support circulation and breathing. The overall mortality rate is probably 5-7%, but many people who survive have longstanding handicaps. Though the media may be exaggerating some aspects of the story, they’re right that this is a serious infection not to be taken lightly.

Though no prevention strategy will be 100% effective, some steps can help prevent wounds from developing a more serious infection:

  • Clean scrapes and cuts well, especially if there is dirt involved. The most important step in wound care is irrigation—spraying water into a wound for a long time, rinsing out bacteria and debris. Topical antibiotics (like the OTC ointment Polysporin) can help, but thorough cleaning is essential.
  • Beware of wounds that develop signs of infection. These include warmth, swelling, and pain—especially pain that’s worse than expected from the degree of the wound. A few hours after a cut or scrape, a child ought to be feeling better and should continue feeling better. A wound that has increasing symptoms or pain beginning after the injury is a red flag that needs evaluation by a medical professional.
  • Though necrotizing fasciitis itself cannot be prevented by vaccination, it is still essential to keep your tetanus vaccines up to date to prevent other very serious complications of wound infections.
Photo: iStockphoto

Posted by: Roy Benaroch, MD, FAAP at 6:10 am

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