Science
AP/UTMB-Galveston, Ashok K. Chopra, Ph.D., and Dr. Leon Bromberg
- A daycare teacher from Houston thought an injury on his foot had caused a blister to form, but the rapid spread of infection caused him to seek medical treatment.
- Doctors recognized that he had been infected by bacteria that cause necrotizing fasciitis, or flesh-eating disease, and were able to stop the infection by amputating his foot before it spread further.
- These infections are rare but need to be treated urgently or they can be fatal.
It started with what appeared to be a blister.
Raul Reyes, a 26-year-old Houston daycare teacher, had hurt his foot at work. It was swollen and soon, a blister formed, which he thought was caused by his shoe rubbing his swollen foot.
When Reyes woke up the next morning, the blister covered his whole foot. A medical clinic rushed him to the hospital. In the emergency room, x-rays revealed he had a serious, quickly-spreading infection.
Reyes was rushed into surgery.
"Thirty minutes pass and I see the doctor come out," Joseline Reyes, who is married to Raul, told the Houston Chronicle. "She tells me that she tried to get as much bacteria out but that they had to amputate his foot in order to save his life."
The infection in Reyes' foot turned out to be necrotizing fasciitis, also known as flesh-eating disease. These infections, caused by a variety of bacteria, cause soft tissue such as skin, muscle, ligaments, blood vessels, and fat to die. The infection needs to be killed or cut away before it spreads.
Reyes lost a foot and does not have medical insurance to cover a prosthetic, according to a GoFundMe crowdfunding campaign raising money to cover that prosthesis. But he did survive the surgery and is recovering now, according to that campaign.
A mysterious case of flesh-eating disease
Necrotizing fasciitis can be caused by an infection with a number of different bacteria, according to the CDC, such as group A Streptococcus bacteria, Klebsiella, Clostridium, E. Coli, Vibrio vulnificus, and others.
Whatever the cause, these infections needed to be treated urgently, with antibiotics to kill the bacteria and surgery to remove affected tissue and stop the spread. Flesh-eating disease kills close to 30% of those infected.
The loss of a limb is devastating for anyone, but if Reyes had waited any longer to seek treatment, it's likely he would have lost more than a foot - very possibly his life.
The big question is how he was infected in the first place.
Many flesh-eating bacteria infections are acquired when an open wound is exposed to bacteria, often in brackish, coastal water, like the water found near Houston. But Reyes hadn't been in the water recently. However, many of the bacteria that cause these infections can also live in soil or other locations.
In this case, doctors think that an ingrown toenail could have been the wound that allowed the infection to start.
CDC
Signs of a rare but deadly infection
The idea that something as slight as a small cut could potentially expose you to deadly bacteria is disconcerting. But it's worth noting that despite media coverage of these cases, they are still extremely rare.
One estimate says there are between 600 and 1,200 cases from the most common cause, group A strep, each year - though the CDC reports that this is likely an underestimate.
The most important thing to know is that anything that appears to be a rapidly spreading infection should be immediately seen by a medical professional.
People are more susceptible to necrotizing fasciitis if they have a condition or illness that weakens their immune system, but either way, the bacteria usually causes infection at the site of a wound. Normally, the condition is accompanied by extreme pain that may start as soreness, like with a pulled muscle, but quickly becomes more severe. Spreading areas of discolored skin are a sign of the condition.
If any of these symptoms are present after a wound appears, or if you have fever, chills, or vomiting, the CDC advises seeing a doctor for treatment immediately.