Hong Kong woman with ‘flesh-eating bacteria’ has leg amputated, cultures reveal Vibrio vulnificus
Hong Kong Image/CIA
Hong Kong health officials are investigating a case of a 37-year-old woman who presented to the hospital with right calf pain and swelling, which was diagnosed as necrotizing fasciitis, according to a Centre for Health Protection (CHP) press release Dec. 11.
The timeline of the case is as follows–the woman, with no history of chronic disease, presented with right calf pain and swelling on December 5. She was admitted to Kwong Wah Hospital the following day (December 6). She was diagnosed as having necrotizing fasciitis and right leg above-knee amputation was performed on the same day.
Cultures taken on samples from the patient revealed the bacterium, Vibrio vulnificus, one cause of necrotizing fasciitis. She is currently being treated in the ICU and reportedly in serious condition.
The CHP says the investigation is ongoing.
The most common organism that causes this devastating disease is Streptococcus pyogenes (group A strep), however other bacteria have been implicated (Clostridia,Vibrio, and in the case of Aimee Copeland, Aeromonas.).
It’s called “flesh eating bacteria” because of how it destroys the skin and soft tissue.
This is the same bacteria that cause relatively mild infections like strep throat and impetigo. However, rarely a strain of the bacteria produce toxins and enzymes that make the infection spread quickly through the flesh.
Though rare, with approximately 10-15,000 new cases annually according to the CDC, it is very serious with a fatality rate of approximately 30%.
So how is someone infected? Usually the bacteria enter the body through an opening in the skin, quite often a very minor opening, like a paper cut.
It can also happen following a major trauma or surgery, and in some cases, there appears to be no identifiable point of entry.
The bacteria is transmitted through respiratory droplets or contact with the secretions of from someone who has group A strep and this gets on a person’s hands or directly into a wound.
According to WebMD, the symptoms of necrotizing fasciitis start with pain from an injury that gets better over 24 to 36 hours and then suddenly gets worse. Often the pain is much worse than would be expected from the size of the wound or injury.
Other symptoms may include fever, chills, and nausea and vomiting or diarrhea. The skin usually becomes red, swollen, and hot to the touch. If the infection is deep in the tissue, these signs of inflammation may not develop right away.
The symptoms often start suddenly (over a few hours or a day), and the infection may spread rapidly and can quickly become life threatening. Serious illness and shock can develop in addition to tissue damage. Necrotizing fasciitis can lead to organ failure and, sometimes, death.
The infection is diagnosed based on symptoms and how fast the infection progresses. It can also be cultured to identify the offending bacteria.
Typically, by the time a person is seen by their doctor they are very sick. This is a medical emergency that requires hospital admittance, high dose antibiotics and supportive care for organ failure and shock.
Members of the public are reminded to adopt the following preventive measures to avoid wound infections with Vibrio vulnificus:
* Avoid exposure of open wounds or broken skin to seawater or salty water;
* Wounds should be thoroughly cleaned and properly covered; and
* Wear thick rubber gloves when handling raw shellfish.
This link to the National Necrotizing Fasciitis Foundation has “preventive” measure recommendations.
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