Invasive strep takes the life of a patient in Gillette, Wyoming hospital
One of two patients admitted to a Gillette, Wyoming hospital for treatment of the invasive “flesh-eating bacteria” has died Wednesday, according to an Associated Press report.
43-year-old Caucasian male with necrotizing fasciitis. Preoperative photograph on the day of admission. Extensive erythema and necrosis of the left leg.Photo credit: Piotr Smuszkiewicz, Iwona Trojanowska and Hanna Tomczak via wikimedia commons
The unidentified patient died from a severe form of streptococcal disease known as necrotizing fasciitis at the at Campbell County Memorial Hospital (CCMH).
Hospital Infectious Diseases specialist, Dr. Christopher C. Brown said the person who died had close contact with the other patient before they arrived at the hospital. Both were battling necrotizing fasciitis.
A third patient had a serious Strep infection but, contrary to previous reports, did not have flesh-eating bacteria, Brown said.
In a CCMH news release this week, three weeks ago, the Campbell County Hospital District saw one patient with an infection which was later confirmed as a case of Strep A. Initial findings, three weeks ago, did not indicate the severe presentation of the disease. The hospital continued to conduct further analysis of the disease strain, and has confirmed at least two cases of invasive Strep A have been seen at the hospital in the last three weeks.
According to Wyoming State Epidemiologist, Tracy Murphy,“Strep A is a fairly common organism. Unfortunately, some people with increased risk of household contact, compromised immune systems, diabetes, or are over age 65 can get a severe form of the disease. And some strains of Strep A are more prone to cause severe disease than others. There is no evidence to suggest a public health threat to the community.”
The “flesh eating bacteria” is actually a relatively rare bacterial infection technically known as necrotizing fasciitis.
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, it is very serious with a fatality rate of approximately 30%.
So how does someone get 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.
This link to the National Necrotizing Fasciitis Foundation has “preventive” measure recommendations.
For those who would like more information on the recent Strep A cases, feel free to attend a public forum with Dr. Christopher C. Brown, Infectious Diseases specialist, on Friday, September 28 at noon at CCMH fifth-floor classrooms 1 and 2.
[…] incident coincidentally came at the same time when two patients at the Campbell County Memorial Hospital were infected and being treated for necrotizin…. One of the patients passed away Wednesday. Image/David Benbennick via Wikimedia […]