TeachableMedicalNews article 07052019

Teachable moment in classrooms:

  1. tissues chapter – connective tissues as conduits for spreading infection
  2. muscle chapter – fascia as a conduit for spreading infection
  3. immune system chapter – immune defense must work right to defeat bacterial invaders

 

                    How come flesh eating bacteria are so damaging?

The news item:  Several news outlets, including ABC news

https://abcnews.go.com/US/wireStory/family-woman-dies-flesh-eating-disease-florida-64068630

reported during the summer of 2019 on the occurrence and fatal consequences of infection by flesh eating bacteria. She got this infection from a scrape wound while walking in the ocean.  The grandmother died 13 days after the infection.  The article mentions a possible causative bacterium, Vibrio vulnificus.

 

So, Why Do I Care??

While necrotizing fasciitis is a rare disorder affecting about 5-10 people in a million, it is devastating on the infected person.  Because the best treatment is to surgically remove the infected body parts, the infected person will likely lose fingers, toes, foot, leg, and sometime internal organs need to be removed.  Treatment is a must, as the bactria will destroy life maintaining organs.  Even with expert treatment about one out of 3 infected people will die of this infection.

 

Plain English, Please!!!

So, let’s talk about the disorder itself.  Necrotizing fasciitis simply means death of soft tissue.  We have soft tissue ( a certain type of connective tissue) under our skin, around all muscles, inside our abdominal organs, and around our teeth.  When a colony of bacteria grows inside our bodies, they destroy the soft tissues easier than other parts, so these bacteria spread through the soft tissue. These bacteria chew our flesh, and the result is a gross looking, bloody body surface.  Many different bacteria types, not just the Vibrio mentioned in the article may cause this destruction.

 

Next, let’s talk about the result of such infection.  Ok, so bacteria get into our wounds every day, but we don’t get flesh eating infection every day.  Flesh eating disorder happens when our own defenses, our immune system, is not up to snuff.  Normally our immune system would be hunting down and killing the bacterial invaders. For some diseases a side effect is the impaired immune system.  Imagine that in a town the police department is under staffed, so complaints of criminal activity may not get immediate attention.  If you don’t kill bacterial invaders then they will multiply quickly, and from one criminal an entire organized crime family is created.  Once that strict law enforcement by our immune system is gone, the invaders multiply and spread through the easy path of soft tissues.  In diabetics, in people with blood vessel disorders, in low immunity circumstances such as elderly, organ transplant recipients, a small scale bacterial invasion may lead to a life threatening spread of those bacteria.  Large numbers of bacteria will then destroy soft tissue.