Posts Tagged ‘necrotizing fasciitis’

What else can a strep infection lead to?

Saturday, December 24th, 2011

tiny bacteria can lead to huge consequences

I wash my hands more frequently these days, not as a sign of OCD, but just from common sense. Familiar bacteria, ones that some of us carry and that our school-age kids may encounter several times a year, can rarely cause horrendous, life-threatening problems. WebMD¬†has a short review of one of these diseases, one that physicians call necrotizing fasciitis (NF), but most non-medical folk know of as “Flesh-eating Strep.”

I had read about this complication of the same bacteria that can cause strep throat, but prior to moving to Fort Collins in 1999, had never known of someone who developed it. Then, shortly after arriving here we joined the Newcomers Club. We met lots of people who came to the “Choice City” after retiring and heard of one who subsequently lost a spouse to the disease.

After that I paid a lot more attention to the entity. As I read considerably more about NF, I realized that streptococcal infections weren’t its only cause, but I’ll focus on strep today.

NF isn’t the only major complication caused by Group A streptococci (GAS). There’s a toxin-caused deadly illness called toxic shock syndrome. This has been around in the medical literature for about three decades. I became aware of it in December 1980 when the New England Journal of Medicine¬†published an article describing 38 cases of this dire syndrome where patients, usually women who were menstruating and using tampons, developed high fever, low blood pressure and multi-organ failure, as well as sloughing off the skin of their palms and soles. The causative agent often was staph and blood cultures were often positive for staphylococci.

Yet half of the cases in a 2010 review did not involve menstruating women, in fact a quarter of the patents were men. Over the past thirty years, tampons have been improved so that the number of cases invoking their use has gone down markedly.

But the syndrome is still around and other bacteria, especially GAS, have been involved. Many of the patents who developed strep-associated toxic shock syndrome (STSS) had underlying chronic diseases (e.g., diabetes, cancer or alcoholism) or had recent surgical procedures. Some researchers have implicated a specific toxin in strep TSS.

When GAS bacteria find their way into areas where they are rarely seen, they can cause diseases much more severe than the usual strep throat or skin infections. These illnesses are called “invasive group A streptococcal disease.”

It’s estimated that an average of 10,000 cases of invasive GAS disease with a mortality rate over 10% happen in our country every year. Necrotizing fasciitis and STTS are even more likely to be lethal. A fifth to a quarter of those who develop NF die and half of those who have STTS.

Remember most of the millions of cases of strep infections that occur yearly here are relatively mild, but even those are nothing to be ignored. Good hand washing technique is crucial and I’ve provided you a link to the Mayo Clinic’s article on thus subject.

The CDC article stresses that anyone who develops an infected wound, particularly if they also have a fever, should see a physician immediately. You may save your life if you do so.