A sixty-year-old diabetic man was admitted to the Hospital Escuela in Honduras on Feb. 1. He had been suffering from a severe gangrene around his genitals for weeks.
Three days later, the hospital reported him dead, the first victim of necrotizing fasciitis, commonly known as “flesh-eating bacteria.” In Spanish-speaking countries, it is popularly known as “come carne”. So far, six cases have been admitted to the hospital in the past three weeks and three people have died from this bacterial infection.
The director of the hospital and the infection control committee considered this situation an “epidemic.” Although most of the patients had diabetes mellitus, which makes them prone to the infection, all patients were diagnosed in La Esperanza region (Intibucá and Choluteca), in western Honduras, and all patients had infections located near the genitals. The type of bacteria which caused this condition is under investigation. Doctors believe the infection is associated with Group A streptococcus bacteria. The hospital has been taking preventive measures to avoid the spread of the bacteria.
Necrotizing fasciitis is a bacterial infection that invades soft tissues such as skin, fat and the tissue covering the muscles. Necrotizing fasciitis infections are usually categorized by the family of bacteria causing the infection. Type 1 infections are caused by two or more bacteria, such as Vibrio bacteria (bacteria typically found in saltwater that cause food borne infections) or Candida fungi. Streptococcus bacteria cause Type 2 infections. Non-pathogenic streptococcal species are often found in the mouth, intestines and upper respiratory tract. Other species of streptococcus are pathogenic and can cause severe infections. Type three infections are caused by Clostridium bacteria.In Central America, there was another come carne outbreak in Cartago, Costa Rica in the summer of 1999 (1). The cause of the outbreak was streptococcus. Nine people were affected from this infection. Two died, one of them a seven day-old baby.
People who have weak immune systems, or have chronic diseases such as diabetes mellitus, cancer, liver or kidney disease, face an increased risk of this infection. However, it can occur in healthy people with surgical wounds and deep skin injuries. During the summer of 2012, many U.S. media outlets reported on necrotizing fasciitis after a 24-year-old from Georgia suffered from a severe necrotizing fasciitis infection as a result of a zip-lining accident. The accident left her with a cut on her leg that required 22 staples to close.
Symptoms include high fever, strong pains, nausea and vomiting, and redness and swelling of the affected area. The infection spreads rapidly and may quickly become life-threatening. Approximately 30 percent of those infected die from this infection, so urgent intensive care is recommended as soon as possible to avoid aggravation. Treatment includes intravenous antibiotics and surgical removal of the necrotic tissue.
(1) A summary of this news article can be found by visiting www.promedmail.org, Archive number: 19990815.1409. Also at The Tico Times, 6 August 1999.