Flesh-eating bacteria hospitalizes another victim: New S.C. mom

The rare disease commonly known as flesh-eating bacteria has claimed another victim: a South Carolina woman who had just given birth to a healthy set of twins and who noticed an unusual spot on the back of her leg.

Lana Kuykendall, 36, is a paramedic, and her profession might have helped save her life. She recognized the spot as something to be concerned about -- perhaShe has undergone four surgeries so far to remove dead flesh as doctors scramble to keep one step ahead of the disease formally known as necrotizing fasciitis. So far, Kuykendall has not suffered any limb amputations -- often a devastating result of the disease.

It remains unclear how Kuykendall might have contracted the bacteria.

Her husband, Darren, told GreenvilleOnline.com that group A strep bacteria caused the disease. According to the federal Centers for Disease Control and Prevention, group A strep typically causes only a routine infection in the body, such as strep throat. But on rare occasions, when the bacterium manages to breech the body's natural barriers and make its way into the blood, muscle or lungs, it can become life-threatening.

Kuykendall's husband told Greenvilleonline.com that Kuykendall is still in the midst of the fight for her life.

"She's still critical," he said. "It's been a nightmare."

He said he and his wife could literally watch the disease's progression as they sat in the hospital awaiting treatment. "The longer she sat there, the bigger that spot got," he said. "It was initially the size of a 3-by-5 index card. But it got bigger and bigger. It moved a quarter of an inch in half an hour."

He told the news website that relatives and friends are taking care of the twins, Abigail and Ian, who were born May 7.

Kuykendall's case comes on the heels of the highly publicized case of a Georgia college student who is also fighting to survive necrotizing fasciitis.

Aimee Copeland was spending a day in the outdoors on May 1 when she hopped on a homemade zip line for a ride near the Little Tallapoosa River west of Atlanta. The line snapped, and Copeland fell, suffering a deep gash to her left calf. Experts believe that wound was the entry point for a dangerous bacterium to take hold in her body.

Copeland's leg has since been amputated, and a family blog says she will also suffer the loss of her fingers. Doctors are hoping to save the palms of her hands.

Antibiotics are used to treat necrotizing fasciitis, but not all drugs work. That's why early diagnosisand aggressive treatment is crucial, experts say.ps a blood clot -- and promptly sought medical help.

Flesh-eating bacteria risk rare despite Ga. student case

Aimee Copeland, the Georgia graduate student battling a life-threatening, flesh-eating bacterial infection, was still on a respirator Tuesday in a hospital in Augusta, Ga., but she is improving, her father says.

Andy Copeland told the Associated Press that doctors still believe they will have to amputate his daughter's fingers, though they think they can save her palms and right foot. She has lost most of her left leg.
Aimee, 24, still faces months of recovery to treat the infection that developed after she cut her leg when a zip line snapped over a river in Georgia May 1. The gash in her left calf is believed to be the entry point of the infection, necrotizing fasciitis.

It is caused by some of the same Group A strep bacteria that also cause common strep throat and impetigo. Only about 750 cases of flesh-eating bacteria occur each year, usually caused by a type of strep germ, the Centers for Disease Control and Prevention says. About one in five cases prove fatal. But Copeland's infection was caused by another bacteria, Aeromonas hydrophila, the AP reported. Those cases are even rarer.
William Schaffner, an infectious-disease specialist at Vanderbilt University Medical Center in Nashville, discusses how this atypical infection could occur and how it can be treated.
A: It is a very deep soft-tissue infection. Fasciitis refers to the connective tissue covering the muscle. One of the things that characterizes these infections is that because they are deep, they are removed from oxygen. It's not like an infection on the surface. So you need bacteria or a combination of bacteria that can function in a largely oxygen-free environment. And there are a number of different ones, including Aeromonas hydrophila, that can do that.
A: It lives in warm freshwater, usually brackish freshwater such as lakes and streams. That sort of water got into the young lady's deep wound. It can live in an oxygen-abundant environment, but if you put it down in a deep wound and close the wound with stitches, removing it from oxygen, it can switch its metabolism so that it can also function in an oxygen-poor environment, and this is what happened to her.
A: 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 tends to be known for causing mild diarrhea.
A: The primary symptons are usually pain, because the fascia is being destroyed and the muscle itself is in the process of being destroyed. Initially, there may not be a great deal of fever, curiously enough. The wound is on the surface and the infection is deep down, and the wound looks fine. It's not inflamed, it's not puffy, there's no discharge, sutures are put in and they stay intact. There's a disconnect between the pain and the wound. So the conclusion, without a lot of fever, is often that it must be a bone bruise or there's bleeding deep in the wound that's causing pain. Appropriate treatment is delayed until it becomes more obvious. But you've lost a lot of ground because the infection is so subtle and sneaky.
A: First, antibiotic care. Often a variety is needed because Aeromonas is resistant to some common antibiotics. More important is aggressive surgery to the local wound, cutting away the diseased tissue and exposing the depth of the wound to oxygen. It's common for surgeons to have to go back a second or even third time to keep up with the spreading infection. … Rigorous supportive care is necessary, because the infection can have systemic effects.

Eaten alive: Hilton Head man recovers from flesh-eating infection Read more here: http://www.thestate.com/2012/05/15/2276351/eaten-alive-hilton-head-man-recovers.html#storylink=cpy

By TOM BARTON - tbarton@islandpacket.cHILTON HEAD ISLAND — By most accounts, Barry Ginn should be dead. Fortunately, the Hilton Head Island resident has several guardian angels watching out for him.

Ginn survived a rare bacterial infection that attacks soft tissue and muscle, often leading to amputation and, in some cases, death.

In February, Ginn had severe pain in his shoulder and a fever. He thought he had torn his rotator cuff again and went to the doctor

Read more here: http://www.thestate.com/2012/05/15/2276351/eaten-alive-hilton-head-man-recovers.html#storylink=cpy

omInstead, he learned — nearly too late — that bacteria was ravaging his body, eating him from the inside out.

To save him, three doctors removed most of Ginn’s upper shoulder and a large portion of his upper arm. He underwent nine surgeries in four days.

Now, Ginn is trying to raise awareness about the infection, necrotizing fasciitis, and send a message of hope as a young Georgia woman fights for her life at an Augusta hospital.

“It kills you, and it kills you fast if you don’t catch it,” Ginn said.

He’s just now beginning to understand what happened to him.

“It’s about awareness,” Ginn said. “The odds are better of you winning the (lottery) than catching this flesh-eating bacteria. But guess what? I bought Powerball tickets and lost. But I did, however, get the flesh-eating infection. The biggest mistake I made was I wasn’t honest with myself or my doctors.

“If you suspect there’s something amiss, get to a doctor ... And if the skin is hot to the touch, something is going on and get to a good hospital ASAP. Don’t screw around.”

Ginn went to his primary doctor and described his symptoms, all consistent with a torn muscle in his shoulder. Three days later, a friend drove him to Savannah to consult a surgeon, who concurred.

The doctor advised Ginn to schedule a follow-up in two weeks.

On the way home, Ginn’s friend noticed he was sweating profusely. Ginn shrugged it off, thinking it was normal for someone with a torn rotator cuff.

Only now does he realize the fever caused by the infection affected his thinking. An emergency room attendant would later ask him if he was drunk.

His friend dropped him off at home. Another stopped by a few days later to find Ginn stumbling around his condo and called 911. Ginn was rushed to Hilton Head Hospital and then to MUSC.“I was dying,” he said. Once at MUSC, surgeons worked quickly to cut away dead tissue. In a brief moment of clarity, he said, he remembers telling his daughter: “Don’t let them take my arm, unless it’s life or death. If I die, cremate me, take my ashes and scatter them in the waters off Bear Island.”

The surgeons saved his arm. Doctors later told him they discovered he had an aggressive antibiotic-resistant staph infection and compromised immune system that likely brought about the necrotizing fasciitis.

He’s unsure how he got the infection.

Flesh-eating Aeromonas cases are considered extremely rare. The Centers for Disease Control and Prevention does not keep statistics, and only a few cases have been reported in medical journals.

The most common form of flesh-eating bacteria is Group A streptococcus, the same bacteria that causes strep throat. There are various strains of the bacteria, some of which are more harmful than others. Under the right conditions, necrotizing fasciitis can occur, according to the National Necrotizing Fasciitis Foundation.

The Centers for Disease Control and Prevention estimates there are about 9,000 to 11,500 U.S. cases of Group A streptococcus each year. About 20 percent of the cases of necrotizing fasciitis are fatal, according to the CDC.

South Carolina health officials do not track cases of necrotizing fasciitis, but do track about 50 cases of Group A strep per year that could lead to the flesh-eating infection, according to Dr. Jerry Gibson, state epidemiologist.

Read more here: http://www.thestate.com/2012/05/15/2276351/eaten-alive-hilton-head-man-recovers.html#storylink=cpy

Family enjoys laughter even as college student battles flesh-eating bacteria

(CNN) -- "Fun" is not the word that one would expect to hear from a father as he watches a daughter's courageous struggle against flesh-eating bacteria -- a battle that has pushed her to the brink of death and back -- but Andy Copeland says he's trying to enjoy life with his family despite their trials.

"Today was a really huge day," Copeland wrote Monday evening inhis blog that details his daughter's battle. "Let me just say that we had a lot of fun with Aimee today."

Aimee Copeland, 24, lies in a hospital bed, hooked to respirator which is helping her breathe. She has already lost a leg and part of her abdomen to the virulent bacteria and may lose more, including her fingers.

But yet there was reason for hope Monday.

"We saw Aimee laugh and smile," Andy Copeland said. "She told us some things she wanted, we played games with her and she was very stimulated. It was an amazing time."

On a Facebook post, he wrote that doctors have used words like "astonishing," "confounding" and "mind-boggling" to describe the young woman's recovery.

"We really don't see the suffering side of it. We see the miraculous survival," Copeland said. "I think that's the story that's inspired us, that's the story that's inspired, I think, the nation at this point."

The master's student in psychology at the University of West Georgia was out with friends on May 1 near the Little Tallapoosa River, about 50 miles west of Atlanta, when she grabbed onto a homemade zip line. It snapped.

The accident left her with a gash in her left calf that took 22 staples to close.

Three days later, when the pain continued, a friend took her to an emergency room, where she was diagnosed with necrotizing fasciitis and flown to Augusta for surgery.

She had contracted the flesh-devouring Aeromonas hydrophila. The bacterium is "remarkably common in the water and in the environment," according to Dr. Buddy Creech, an assistant professor of pediatric infectious diseases at Vanderbilt University.

"When it gets into those deeper tissues, it has a remarkable ability to destroy the tissues that surround it in sort of this hunt for nutrition," he said. "When it does that, those tissues die, and you see the inflammation and the swelling and the destruction that can be very difficult to control."

In most cases, people contract the bacteria by swallowing them, resulting in diarrhea. Aimee Copeland's case was rarer. Her wound became infected, "and the infection (ran) wild," Creech said.

A blog set up by the University of West Georgia psychology department said Aimee Copeland will suffer the loss of her fingers.

"However, physicians have hope of bringing life back to the palms of her hands, which could allow her the muscle control to use helpful prosthetics," the blog said. "They are awaiting a safe time before embarking on surgery for this."

Students at the University of West Georgia are rallying to Copeland's aid. A blood drive to benefit Aimee will be held Tuesday at the student center. A second blood drive will be held next week in Gwinnett County, where the Copelands live

"The response has just been unbelievable," Gary Duke, owner of the Sunnyside Cafe where Copeland worked, told CNN affiliate WSB-TV.

Speaking to CNN on Monday, her father said doctors were assessing "day by day, or even hour by hour."

Andy Copeland has told his daughter that one day, the family will celebrate Aimee Day -- when she will be able to breathe on her own. "We're going to celebrate that day forever for the rest of your life," he told her. "It's the day that my daughter was delivered from this horrible, horrible disease."

Monday was a step in the right direction as the mood lightened and Aimee's condition improved.

"The nurses were even laughing and saying it sounded like a game show in Aimee's room," Copeland said.

It's a show the family hopes will go into reruns.

Flesh-Eating Bacteria, Infection That Claimed Aimee Copeland's Foot, Expained

Aimee Copeland, the 24-year-old Georgia student who has already lost her leg to necrotizing fasciitis, a rare, flesh-eating bacteria, is in critical condition and may also lose her hands and her other foot, according to news reports.

ABC News reported that Copeland showedevidence of an infection by the flesh-eating disease days after she went to a doctor for a deep cut she suffered from a homemade zip line fall.

Even though the doctors cleaned and closed the wound, it became infected, the Associated Press reported, most likely from bacteria at the zip line site.

"I couldn't conceive of what it would be like for my daughter to lose her hands and the only other foot she has, as well, and that appears to be what is going to happen," her father Andy Copeland told ABC affiliate WSB-TV. "The most important thing is my daughter is still alive."

The Associated Press reported that the specific bacterium that infected Copeland is called Aeromonas hydrophila. This kind of bacteria usually causes diarrhea (when people swallow water contaminated with it), and cases where the bacteria cause flesh-eating diseases are very rare, the AP reported.

ABC News reported on a 2010 study in the journal Clinical Microbiology Reviews, that showed that necrotizing fasciitis from Aeromonas bacteria has a death rate of more than 60 percent. But according to a 2007 study in the World Journal of Emergency Surgery, death rates from the condition can range anywhere from 25 to 73 percent.

The risk for necrotizing fasciitis increases when a person's immune system is already weakened; when a person has other health problems like diabetes or kidney disease; when there are cuts on the skin; when the body has decreased infection resistance because of medications; and when a person has just the chickenpox or another kind of viral infection, WebMD reported.There are about 10,000 to 15,000necrotizing fasciitis infections each year in the U.S., with 2,000 to 3,000 deaths, according to the Wisconsin Department of Health Services.

According to the 2007 World Journal of Emergency Surgery study, necrotizing fasciitis can be hard to diagnose -- but being too slow to diagnose it carries an increased risk of death.

The first symptoms are typically seen in the first day, and include new wounds elsewhere (even though the original wound usually doesn't yet look infected), the sensation of pain somewhere near the original wound and flu-like symptoms.

Three or four days later, the part of the body where the infected wound is may start to swell up and dark marks and rashes may occur. The actual wound may also start to have a "bluish, white, or dark, mottled, flaky appearance," according to the study. And within four or five days, the body's blood pressure may decrease and may experience septic shock. The person may also become unconscious.

Treatments for necrotizing fasciitis may include antibiotics and surgery -- as Copeland received -- so that the infected parts of the body are removed and don't spread the infection elsewhere, according to WebMD. Other treatments may be needed for the other problems that come with infection -- like possible organ failure or shock -- and hyperbaric oxygen therapy may also be used to stop the body's tissue from dying, WebMD reported.

News reports did not say specifically what other treatments Copeland is undergoing aside from the amputation of her leg and the potential amputation of her hands and other foot, though ABC News noted that she breathes through a ventilator.