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Published Date: 2012-03-17 15:55:18
Subject: PRO/EDR> Necrotizing fasciitis - USA: (HI), Vibrio vulnificus suspected
Archive Number: 20120317.1072640
NECROTIZING FASCIITIS - USA: (HAWAII), VIBRIO VULNIFICUS SUSPECTED
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http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
[1]Date: Thu 15 Mar 2012
Source: KHON [edited]
http://www.khon2.com/news/local/sto...ss=3030&utm_source=dlvr.it&utm_medium=twitter
A 49-year-old man was found Saturday morning, 10 Mar 2012, by his mother, unconscious inside his Lihue, Kauai apartment. He was rushed to Wilcox Memorial Hospital where doctors discovered that he was suffering from a "flesh-eating" disease, also called necrotizing fasciitis.
The man is in stable condition but his mother says he has gone through multiple surgeries to cut out the diseased skin and tissue. "We are looking for a bed on Oahu for him to be transferred to. There is no bed we've been told, but he does need major reconstructive surgery and therapy," said the mother.
Doctors say such infections are not uncommon. "Just today I saw someone for that, a consultation for a necrotizing skin and soft tissue infection," says Dr. Heath Chung, Infectious Disease Specialist at the Queens Physicians' Office Building. Dr. Chung says anyone can get it. He's seen four patients in the past month, where bacteria got into the body and released toxins, which eat away tissue.
"You could get it from stepping on a nail or stepping on a tack. I had a person I saw a couple weeks ago that got a scrape while running and he scraped his leg on a tree and sure enough it turned out to be a necrotizing infection," says Dr. Chung.
Symptoms include bloody blisters and swelling. "If they come in with excruciating pain, but it doesn't look that bad, that's another indicator," says Dr. Chung.
[Byline: Brianne Randle]
--
Comunicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
*****
[2]
Date: Fri 16 Mar 2012
Source: Hawaii News Now [edited]
http://www.hawaiinewsnow.com/story/17171682/kauai-man-fighting-flesh-eating-bacteria
A man on Kauai is fighting a rare case of flesh-eating bacteria that is spreading rapidly. He was found unconscious Saturday morning, was in the intensive care unit at Wilcox Memorial Hospital and now has since been transferred to an Oahu hospital for treatment.
The patient is now in stable condition. "His breathing tubes were removed," the mother said. "He had a full dinner last night and he's on his way to recovery, but because of the major portions that have been removed, he needs to be seen on Oahu."
The CDC said there are about 100 cases a year of the severe form of necrotizing fasciitis. Medical experts said the disease is not contagious. Instead, what causes people like Stem to get sick are bacteria that enter the skin.
"Usually, there's a trauma," said epidemiological specialist Joe Elm. "A cut, or maybe a severe bruise that gets infected with one of these organisms, and it gets into the deep fascia. And then when it multiples it produces toxins and proteases that allow it to travel really fast." Elm said those bacteria can be found in brown water and other flood waters, which have been in abundance on the Garden Isle during the past several days. The bacteria then wreak havoc beneath the skin.
Doctors say it is very important to treat any cuts before going into the ocean or coming into contact with flood water, which the mother believes happened to her son last week. The experts say there's an easy way to prevent the disease, especially when swimming in the ocean. "When you get out of the water, take a shower. Rinse off, get rid of those of those organisms," Elm said.
[Byline: Ben Gutierrez]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The microbiology of necrotizing fasciitis in this case and other other cases referred to in the first posting are not stated. Group A streptococcus (_Streptococcus pyogenes_) is clearly associated with some cases as well as the combination of enteric aerobic and anaerobic organisms. In this case, however, the mentioning of water exposure suggests that _Vibrio vulfinicus_ is the cause.
It is important to note that not all cases of _V. vulnificus_ infection are acquired from salt water. The disease is often linked to eating raw oysters or other bivalve molluscs such as clams.
_Vibrio vulnificus_, a lactose-fermenting, halophilic [salt-loving],
Gram negative, opportunistic pathogen, is found in estuarine
environments and associated with various marine species such as
plankton, shellfish (oysters, clams and crabs) and finfish. It is
usually found in armer waters. Cases of illness have also been
associated with brackish lakes. Environmental factors responsible for
controlling numbers of _V. vulnificus_ in seafood and in the
environment include temperature, pH, salinity, and increased dissolved
organics.
Wound infections result either from contaminating an open wound with
seawater harboring the organism, or by lacerating part of the body on
coral, fish, etc., followed by contamination with the organism. The
ingestion of _V. vulnificus_ by healthy individuals can result in
gastroenteritis. The "primary septicemic" form of the disease follows
consumption of raw seafood containing the organism by individuals with
underlying chronic disease, particularly liver disease.
The organismcan also enter through damaged skin. In these individuals, the microorganism enters the blood stream, resulting in septic shock, rapidly followed by death in many cases (about 50 percent). Over 70 per cent of infected individuals have distinctive bulbous skin lesions (shown at http://safeoysters.org/images/sym_2_photo.jpg.
A discussion of the disease in humans can be found in ProMED-mail posting "Vibrio vulnificus, salt water exposure - USA (TX)20070719.2317." There are 2 points to be emphasized: that vibrios are normal flora in warm saltwater (not indicative of any sewage contamination) and that most of the life-threatening illnesses occur
in individuals with underlying medical illnesses, including immunocompromised states, chronic liver disease, and diabetes.
So-called normal individuals often just get gastroenteritis. The range of disease due to _V. vulnificus_ can involve more northern geographical areas if the area is affected by a substantial heat wave. - Mod.LL]
[Horrific case photo:
http://www.sarawakeyecare.com/Atlasofophthalmology/neuroophthalmology/necrotizingfasciitis.jpg - Mod.JW]
Published Date: 2012-03-17 15:55:18
Subject: PRO/EDR> Necrotizing fasciitis - USA: (HI), Vibrio vulnificus suspected
Archive Number: 20120317.1072640
NECROTIZING FASCIITIS - USA: (HAWAII), VIBRIO VULNIFICUS SUSPECTED
******************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
[1]Date: Thu 15 Mar 2012
Source: KHON [edited]
http://www.khon2.com/news/local/sto...ss=3030&utm_source=dlvr.it&utm_medium=twitter
A 49-year-old man was found Saturday morning, 10 Mar 2012, by his mother, unconscious inside his Lihue, Kauai apartment. He was rushed to Wilcox Memorial Hospital where doctors discovered that he was suffering from a "flesh-eating" disease, also called necrotizing fasciitis.
The man is in stable condition but his mother says he has gone through multiple surgeries to cut out the diseased skin and tissue. "We are looking for a bed on Oahu for him to be transferred to. There is no bed we've been told, but he does need major reconstructive surgery and therapy," said the mother.
Doctors say such infections are not uncommon. "Just today I saw someone for that, a consultation for a necrotizing skin and soft tissue infection," says Dr. Heath Chung, Infectious Disease Specialist at the Queens Physicians' Office Building. Dr. Chung says anyone can get it. He's seen four patients in the past month, where bacteria got into the body and released toxins, which eat away tissue.
"You could get it from stepping on a nail or stepping on a tack. I had a person I saw a couple weeks ago that got a scrape while running and he scraped his leg on a tree and sure enough it turned out to be a necrotizing infection," says Dr. Chung.
Symptoms include bloody blisters and swelling. "If they come in with excruciating pain, but it doesn't look that bad, that's another indicator," says Dr. Chung.
[Byline: Brianne Randle]
--
Comunicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
*****
[2]
Date: Fri 16 Mar 2012
Source: Hawaii News Now [edited]
http://www.hawaiinewsnow.com/story/17171682/kauai-man-fighting-flesh-eating-bacteria
A man on Kauai is fighting a rare case of flesh-eating bacteria that is spreading rapidly. He was found unconscious Saturday morning, was in the intensive care unit at Wilcox Memorial Hospital and now has since been transferred to an Oahu hospital for treatment.
The patient is now in stable condition. "His breathing tubes were removed," the mother said. "He had a full dinner last night and he's on his way to recovery, but because of the major portions that have been removed, he needs to be seen on Oahu."
The CDC said there are about 100 cases a year of the severe form of necrotizing fasciitis. Medical experts said the disease is not contagious. Instead, what causes people like Stem to get sick are bacteria that enter the skin.
"Usually, there's a trauma," said epidemiological specialist Joe Elm. "A cut, or maybe a severe bruise that gets infected with one of these organisms, and it gets into the deep fascia. And then when it multiples it produces toxins and proteases that allow it to travel really fast." Elm said those bacteria can be found in brown water and other flood waters, which have been in abundance on the Garden Isle during the past several days. The bacteria then wreak havoc beneath the skin.
Doctors say it is very important to treat any cuts before going into the ocean or coming into contact with flood water, which the mother believes happened to her son last week. The experts say there's an easy way to prevent the disease, especially when swimming in the ocean. "When you get out of the water, take a shower. Rinse off, get rid of those of those organisms," Elm said.
[Byline: Ben Gutierrez]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The microbiology of necrotizing fasciitis in this case and other other cases referred to in the first posting are not stated. Group A streptococcus (_Streptococcus pyogenes_) is clearly associated with some cases as well as the combination of enteric aerobic and anaerobic organisms. In this case, however, the mentioning of water exposure suggests that _Vibrio vulfinicus_ is the cause.
It is important to note that not all cases of _V. vulnificus_ infection are acquired from salt water. The disease is often linked to eating raw oysters or other bivalve molluscs such as clams.
_Vibrio vulnificus_, a lactose-fermenting, halophilic [salt-loving],
Gram negative, opportunistic pathogen, is found in estuarine
environments and associated with various marine species such as
plankton, shellfish (oysters, clams and crabs) and finfish. It is
usually found in armer waters. Cases of illness have also been
associated with brackish lakes. Environmental factors responsible for
controlling numbers of _V. vulnificus_ in seafood and in the
environment include temperature, pH, salinity, and increased dissolved
organics.
Wound infections result either from contaminating an open wound with
seawater harboring the organism, or by lacerating part of the body on
coral, fish, etc., followed by contamination with the organism. The
ingestion of _V. vulnificus_ by healthy individuals can result in
gastroenteritis. The "primary septicemic" form of the disease follows
consumption of raw seafood containing the organism by individuals with
underlying chronic disease, particularly liver disease.
The organismcan also enter through damaged skin. In these individuals, the microorganism enters the blood stream, resulting in septic shock, rapidly followed by death in many cases (about 50 percent). Over 70 per cent of infected individuals have distinctive bulbous skin lesions (shown at http://safeoysters.org/images/sym_2_photo.jpg.
A discussion of the disease in humans can be found in ProMED-mail posting "Vibrio vulnificus, salt water exposure - USA (TX)20070719.2317." There are 2 points to be emphasized: that vibrios are normal flora in warm saltwater (not indicative of any sewage contamination) and that most of the life-threatening illnesses occur
in individuals with underlying medical illnesses, including immunocompromised states, chronic liver disease, and diabetes.
So-called normal individuals often just get gastroenteritis. The range of disease due to _V. vulnificus_ can involve more northern geographical areas if the area is affected by a substantial heat wave. - Mod.LL]
[Horrific case photo:
http://www.sarawakeyecare.com/Atlasofophthalmology/neuroophthalmology/necrotizingfasciitis.jpg - Mod.JW]