Flesh Eating Bacteria

[Sanju]

Over the last several years, you've heard stories about a flesh-eating bacteria that can dissolve muscles and skin, leading to amputations and even death. This supposedly new disease may be caused by taking non-steroidal anti inflammatory drugs such as ibuprofin, aspirin, Motrin and Tolectin when you are infected with a beta strep germ (1).

Background
Flesh-eating disease is rare. When it does occur, it is very serious and can lead to death. Flesh-eating disease is the common name for necrotizing fasciitis, an infection that works its way rapidly through the layers of tissue (the fascia) that surround muscles. It destroys tissue and can cause death within 12 to 24 hours.

The symptoms of flesh-eating disease include a high fever, and a red, severely painful swelling that feels hot and spreads rapidly. The skin may become purplish and then die. There may be extensive tissue destruction. Sometimes the swelling starts at the site of a minor injury, such as a small cut or bruise, but in other cases there is no obvious source of infection.

Flesh-eating disease can be caused by a number of different bacteria, including group A streptococcus (GAS). GAS is a very common bacteria. Many people carry it in the throat or on their skin without getting sick.

Pathogenesis
When one gets an infection, certain white blood cells called macrophages produce a chemical called tumor necrosis factor, which travels to your brain and causes your body to produce prostaglandins that cause fever and shut off tumor necrosis factor. Aspirin and nonsteroidal anti inflammatory drugs block the production of prostaglandins, causing the white blood cells to keep on producing tumor necrosis factor. This can allow the bacteria to spread through the body, producing toxins which dissolve tissue and even cause shock and death.
The beta strep bacteria do not dissolve flesh. They produce toxins that dissolve flesh, so once you have this condition, antibiotics may get rid of the bacteria, but they do not get rid of the toxins that cause the damage. Infections with beta strep bacteria can be cured readily if you take antibiotics early enough and avoid taking aspirin or any pain medications.

Warning Signals
First, you develop a sore throat or you cut or bruise your skin or stick yourself with a thorn or splinter. Usually the pain of a throat infection or a wound lessens with time. Progressively increasing severe pain is a signal that you have a serious infection. Contact a doctor immediately if you develop severe pain, a fever, a red streak starts to extend toward your heart, or your lymph nodes start to swell and hurt.

Treatment
Because flesh-eating disease progresses so rapidly, treatment usually involves surgery to remove the infected tissue and antibiotics to fight the infection. There is no vaccine to prevent flesh-eating disease.

[Hero]

You mean to say when there is fever we shouldn't use aspirin or nonsteroidal anti inflammatory drugs ? Plz make clear.

[Sanju]

ofcourse we can use aspirin and other NSAIDs for fever and inflammations. The point here is just that by the use of Aspirin and likes can worsen and fasten the disease.

[Hero]

Good to know about Fournier's gangrene (necrotizing fasciitis). If I were a patient having this disease I would certainly have thanked you. Ur post has nothing new for a physician. Anyways thanks for ur hard effort.

[situ]

thanks ujanas it is usefull post for juniours though hero said it is not new for physicias may be it is minor topic for seniors but this site is for every one .u have explain it clearly what flesh eating bacteria is though u have told it is rare one but we medics should know each n every rare to common one to be a good doctor isn't it??so thanks once again n hope for another new post in future.

[Ramri]

Originally Posted by Hero

..... Ur post has nothing new for a physician.

Everything in medicine is not new for the experienced and seniors physician but they have also went throught the same way as we are now. I didn't get you what do you mean by nothing new for physician? Every disease is not new for the physician because they have already read about it hoina ra

[Hero]

Originally Posted by Ramri

Everything in medicine is not new for the experienced and seniors physician but they have also went throught the same way as we are now. I didn't get you what do you mean by nothing new for physician? Every disease is not new for the physician because they have already read about it hoina ra

I said 'nothing new for a physician' but I am not a physician

[Sanju]

m a junior member too, so i thought it would be helpful.

[Hero]

Originally Posted by ujnas

m a junior member too, so i thought it would be helpful.

Its really wonderful ujnas. I got to learn many things. Really I didn't know that aspirin or NSAIDs treatment, esp.when we have steptococcal infection, may lead to this disease. Now I knew that the risk is increased in those taking aspirin or NSAIDs. During my MBBS, I encountered 2 cases of Fournier's gangrene--in the scrotal region. It really looks deadly, actually it is. Fortunately it is rare. As far as I know, and u have also mentioned, the mainstay of treatment is immediate resuscitation of the patient, followed by aggressive surgical debridement. Prognosis is not bad, but its an ugly disease. Have you seen this case in the ward? Anyways keep it up, really a nice posting.

[Hero]

Originally Posted by situ

..it is usefull post for juniours though hero said it is not new for physicias may be it is minor topic for seniors but this site is for every one...

situ, I am also a junior med student like u, just a senior member of xenoMED. trying to learn from u guys/