When Strep Throat Moves to Your Toes (and Other Limbs)
Strep throat is a serious condition and now even more so after I learned it can be linked to flesh eating disease. Keep your immune system in working order so that you can avoid complications from a seemingly normal malady. You may want to pass this to your friends and family – I just did!
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When I read about the three recent cases of flesh-eating bacteria in the Southeast, I was, of course, concerned.
How, exactly, do you get this infection that can take your limbs or your life?
I put in a call to William Schaffner, MD, past president of the National Foundation for Infectious Diseases and professor and chair of the department of preventive medicine at Vanderbilt University School of Medicine in Nashville.
He told me that the technical name for this disease is necrotizing fasciitis and that it causes the bands of connective tissue that surround muscles, nerves and blood vessels to die.
The scariest part is that this contagious disease can move quickly throughout the body.
I asked him what we all can do to lower our odds of getting this type of infection, and I think you’ll want to hear what he had to say…
HOW THE BACTERIUM INFECTS YOU
The first thing that Dr. Schaffner mentioned eased my mind a bit. Though the disease has gotten a lot of press lately, it’s still considered rare because it affects only about 500 to 800 people in the US each year. That said, if you’re one of those 500 to 800 people, the disease can be devastating.
One reason that it’s not more common is that coming into contact with the bacterium does not usually cause necrotizing fasciitis. In fact, many of us have the culprit, group A Streptococcus, in our throats and sometimes on our skin, without ever knowing it. A dangerous infection results only when the bacterium is able to find its way to a part of the body where it is not normally found—into muscle, fat or any tissue deep inside the body. The bacterium is able to get to those areas by taking advantage of vulnerabilities in our natural defenses, usually through wounds. Even then, our immune systems may be able to kill it off—but not always.
SYMPTOMS TO LOOK OUT FOR
Dr. Schaffner said that when the infection occurs, it usually happens deep inside the body, so it may not be evident on the surface of your skin. Severe unrelenting pain that seems out of whack with your wound is frequently the first symptom. By the time the typical symptoms of infection (such as swelling, redness and fever) do appear, perhaps days later, they might not immediately be thought to be associated with the wound because of the time lag and because up until that point, it may have looked like your wound was healing well.
It’s important to diagnose necrotizing fasciitis early because, as I mentioned, it moves fast. So if you ever have pain that seems surprisingly severe for a particular injury or if you have a sore or wound that is becoming red and swollen instead of healing, get medical attention right away. Doctors suspecting necrotizing fasciitis will get a specimen from the wound to test for the bacterium and then will start treatment immediately.
TREAT IT & BEAT IT
Intravenous antibiotics are just part of the treatment. Surgery is almost always required to remove the infected tissue, and frequently, the surgeons need to go back several times to cut out more diseased tissue. Unfortunately, in some cases, the infection can be so overwhelming that the antibiotics and surgeons can’t keep up. Sepsis (a blood infection), organ failure and even death can result, and, sadly, about 25% of people who get necrotizing fasciitis will die from it.
The best defense against necrotizing fasciitis is to avoid getting wounds altogether, but I know what you’re thinking—that’s impossible. So if and when you do get a wound, even a small one, don’t take your safety for granted. Clean it and then keep it covered to reduce the chance of infection. Applying antibiotic ointment twice daily is a good idea, too, said Dr. Schaffner. And change the bandage daily, or more frequently if it gets soiled.
“It’s especially important for people with chronic illnesses—such as people with cancer or diabetes or those taking steroids—to take good care of even small wounds,” Dr. Schaffner said. “These people are more susceptible to getting flesh-eating bacteria infection because their immune systems are more vulnerable—and when they do get it, they have a poorer prognosis than a healthy person.”
One more very important rule: Any wound beyond a superficial cut or scrape should be looked at by a health professional, who can ensure that it’s cleaned properly. It’s worth the time.
Source: William Schaffner, MD, professor and chair of the department of preventive medicine, Vanderbilt University School of Medicine, Nashville, and past president of the National Foundation for Infectious Diseases, Bethesda, Maryland.
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