Flesh-eating bacteria often a mystery

The death of a Mount Pleasant man from so-called flesh-eating bacteria revives lingering concerns about this unpredictable and fast-acting disease.

Anthony Hills, 55, died Saturday at the Medical University of South Carolina from necrotizing fasciitis, Charleston County Coroner Rae Wooten confirmed Monday.

Family members said Hills had a swollen arm and complained of not feeling well before he went to the hospital, according to The Associated Press. Doctors amputated the arm and were considering amputating his leg before he died.

Hills' death brings to mind the case of Aimee Copeland of Snellville, Ga., who lost her left leg, right foot and both her hands to the bacterial infection after cutting her leg in a May 1 fall from a homemade zip line over a river. The University of West Georgia student is home from the hospital and undergoing rehabilitation, according to posts on her father's blog.

Neither the coroner nor MUSC could give more specifics about Hills' case, but Dr. Michael Kilby, director of infectious diseases at MUSC, talked about the disease in general.

“It's a scary disease,” Kilby said Monday. “Luckily it's very rare. I don't know of any evidence that this is more common this year than it was last year. I think it's the same thing we've been seeing in infectious disease for a long time.”

He and his colleagues see about a case a month. Most of the time, doctors can treat it with intravenous antibiotics and minor surgery; it's rare that the disease requires amputations, he said.

But what scares people is what happens when the infection gets out of control. The bacteria spreads so fast that antibiotics can't keep up with it.

Necrotizing fasciitis sent 59-year-old Barry Ginn of Hilton Head to MUSC earlier this year. He underwent nine surgeries to remove portions of his upper arm and shoulder. He told a reporter he wasn't sure where the bacteria came from.

The bacteria itself is no mystery, Kilby said. Necrotizing fasciitis is usually caused by staph or strep, bacteria that live on the skin all the time, he said.

“It's not really the cause of it that's exotic,” he said. “It's the fact that these common bacteria manage to get below the skin and into tissues where there's not a very good barrier and they can spread much faster and move from just being a pimple on your skin to being something that's able to advance rapidly and kill tissue.”

Yes, the disease can start from a pimple, a scratch or a mosquito bite, wounds that usually heal naturally with no problem, he said.

“For some reason that we don't fully understand, it will dip down deeper and get into the fat and connective tissue where the body is not as good at blocking it, and it can just spread and destroy a lot of tissue,” Kilby said. “This is a rare event. For every 100,000 or 1 million abscesses or little pimples on your skin, one person will have the bad luck of it going deeper and causing more disease.”

Most of the time, the person has a risk factor for infection, such as diabetes or vascular disease, he said. But about a third of patients show no risk factors.

“Sometimes there's just no good clue as to why this person and this case and not another,” Kilby said.

Antibiotics have a hard time stopping the disease because dying tissue no longer has good blood flow, he said. That's when surgery is necessary to try to stay ahead of it.

As far as prevention, it's always a good idea to wash wounds quickly with soap and water, Kilby said. It's also a good idea to see a doctor if the wound or abscess hurts more than normal, redness starts spreading or the skin starts blistering or turning dark, he said.

“If what was just a mosquito bite three days ago is now making your whole arm red and swollen, and you're feeling sick, you should take it very seriously and get it checked out,” he said.

Reach Dave Munday at 937-5553 or twitter.com/dmunday.