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W.Va. man shares battle with flesh-eating bacteria

November 02, 2012|By MARIE GILBERT | marieg@herald-mail.com
  • Brent Hoover of Falling Waters, W.Va., lost a bicep and has a scar caused by flesh-eating bacteria. He said he can no longer throw the ball in baseball, a game he loved to play.
Photo by Yvette May/Staff Photographer

FALLING WATERS, W. Va. — Flesh-eating bacteria might sound like something from a science fiction movie or an episode of "The Twilight Zone."

But it isn't make believe. Instead, it's a real-life horror story — one where a micro-organism enters the body through an open wound and begins to consume tissue from the inside out.

Brent Hoover never suspected he would have fallen victim to such an infection.

He never would have imagined that a swollen arm would have resulted in the loss of a bicep or that he would have four surgeries to remove the bacteria that was destroying his body.

But last May, the 29-year-old man from Falling Waters, W.Va., came face to face with a medical nightmare and considers himself among the lucky ones who have lived to talk about it.



What is flesh-eating bacteria?

Also known as necrotizing fasciitis, flesh-eating bacteria is a misnomer. According to the Centers for Disease Control and Prevention, the bacteria doesn't actually eat the flesh. But when it enters the body through an open wound, it can cause the destruction of skin and muscle by releasing toxins.

And it's a disease that needs immediate action. According to the National Necrotizing Fasciitis Foundation, many cases of the infection are ignored by patients, misdiagnosed or found late.

One in five people die from it. And those who do survive are left with scars.

During the past year, a Georgia student's experience with flesh-eating bacteria resulted in a leg amputation; a Bethesda, Md., teen, who cut her leg developed excessive bruising and swelling around the stitches and underwent 17 surgeries to remove dead muscle and tissue. She currently is learning to walk again.

Then, there is a Michigan woman and a California man who died from the infection — drawing national attention to a medical disorder that many people had never heard of and others knew only by its scary name.

Despite the number of headline cases, necrotizing fasciitis remains very rare, said Dr. Mohammed Ali, a physician with Summit Infectious Diseases, an affiliate of Summit Health in Chambersburg, Pa. Fewer than 1,000 diagnoses occur each year in the United States.

And he doesn't expect that to change.

"There is no evidence to show that there is a sudden flesh-eating bacteria outbreak," he said. "The Centers for Disease Control and Prevention has a surveillance system in place and it does not show a rise in the annual cases of this infection."

Ali said necrotizing fasciitis can be caused by more than one type of bacteria.

"The most common," he noted, "is group A streptococcus, which is generally mild to moderate and easily treated. However, sometimes these bacteria can produce toxins that can cause a death of tissues, which is where the 'necrotizing' is derived from in the name necrotizing fasciitis."



Brett Hoover's story

In Hoover's case, he was hit by a softball in the arm.

"According to the shock trauma nurses, the softball created a hematoma in my muscle where the bacteria attacked my arm," he said.

The bacteria, he was told, might have been dormant in his body.

Hoover said his arm became swollen and bright red and his skin began to stiffen and become tight.

"I thought this was something that would just go away," he said. "It never did and just continued to get worse. There were a few days that I was sick — vomiting and nauseous, sweating. On the day I decided to go to have it checked out, I could not even lift my arm to brush my teeth that morning."

Hoover went to Urgent Care in Hagerstown and was then sent him to Meritus Health Center. He then was transferred to The University of Maryland Shock Trauma Hospital in Baltimore, where he underwent surgery to remove the bacteria from his body.

"I was told by my surgeon that during my first surgery, I went into septic shock, which means the infection was in my bloodstream heading towards my heart," Hoover noted. "My blood pressure had dropped so low that the staff had the EKG machines ready in case I had to be zapped to start my heart back up. In other words, during that first surgery, the doctors and surgeons saved my life with help from above, I firmly believe."

Hoover said he had to have "a good bit of dead, soft tissue and muscle removed from my right arm and pectoral region. (One) bicep in my right arm is completely gone and I have a scar that runs the entire length of my arm from my shoulder to my hand."

"That is the pressure pain I experience all the time. There is a tingling feeling that runs the entire length of my arm along the scarring."

He also can't expose his arm to direct sunlight "because the skin graft is such sensitive skin."

And when it comes to the game of baseball, which he loves, "I can't throw the ball because there is no smooth motion in my arm now," he said. "I feel like the kid in the movie, 'Rookie of the Year.'"



Act fast

Ali said the symptoms of flesh-eating bacteria "may start out like any other illness or injury and the symptoms usually occur within hours following infection. Some people may complain of soreness somewhat like a pulled muscle and the skin may be red or purple with swelling that spreads quickly.  The pain is often described as severe and can be accompanied by fever, chills, diarrhea, fatigue and vomiting. If someone experiences these symptoms after a wound, they should see their doctor right away."

Ali said prompt treatment is essential, which includes strong antibiotics. "However," he noted, "sometimes the toxins from these bacteria can destroy tissues and reduce blood flow; therefore, the antibiotics may not be able to reach all of the infected areas.  In this case, rapid surgical removal of the dead tissue along with antibiotics can be crucial to stopping the infection."

Ali said hyperbaric oxygen therapy (HBOT) might also be prescribed.

"HBOT allows the body's natural wound-healing systems to work better and speed up the healing process," he explained."Your body's tissues need an adequate supply of oxygen to function. When tissue is injured, it requires even more oxygen to survive.  Hyperbaric oxygen therapy increases the amount of oxygen your blood can carry. An increase in blood oxygen promotes healing and helps fight infection."

If you are generally healthy, have a strong immune system and practice good hygiene and proper wound care, Ali said your chances of getting necrotizing fasciitis are very rare.

"Good wound care is the best way to prevent bacterial infections, no matter what type of organism," he said. "So, don't delay first aid of even minor, noninfected wounds like blisters, scrapes or any break in the skin."

If you do develop signs of an infection, he added, see your health care provider immediately.



Being thankful to be alive

Hoover said some days it's hard to stay positive because of the little things that are now difficult to deal with.

But he considers himself a fortunate man.

"I am thankful to my employer, Bowman Logistics in Williamsport, for holding my job for me until the end of September when I was able to return to work," he said. "Knowing that I had a job to come back to played a role in my speedy recovery and helped me to concentrate on getting healthy again."

He also feels blessed to have the support of family and friends "who sent prayers out. Without those people and their prayers, I may not be here right now."

"And I realize that I am lucky to have my arm and very lucky to be alive," he said. "I was told by a doctor that a person has a better chance of winning the lottery than getting nectrotizing fasciitis."

Hoover said by sharing his story he hoped to educate the public about an infection that might be a mystery to many people.

"If you get cut or scratched and the area turns red and is tender and painful and doesn't go away, please go have it checked out immediately," he said. "I was very lucky that I didn't end up in worse condition. I waited a few days thinking it would go away. I very easily could have died or lost my arm."

If one good thing has come out of his encounter with flesh-eating bacteria, it's been the opportunity to reconnect with friends he hadn't seen in a while.

"But I say instead of waiting on a tragic thing to happen, contact the people you care about now," he said. "Every day tell your family and friends how much you love them. Life is a precious thing. We don't know what crazy experience we may face when we wake up in the morning. Take nothing for granted and be as positive as you can be. The things I used to think were terrible now are really not that bad."


To learn more ...

National Necrotizing Fasciitis Foundation's purpose is to raise awareness about the problem and to offer resources and support. More information about necrotizing fasciitis or flesh-eating bacteria is available at www.nnff.org

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