* Third recent case in Georgia, South Carolina
* Doctors unsure what bacteria caused the infection
* Waterborne bacteria blamed for Georgia woman’s infection
(Adds comment, details)
By Harriet McLeod
CHARLESTON, S.C., May 17 (Reuters) – A new mother of twins
in Greenville, South Carolina, is the latest victim of a rare
and potentially fatal flesh-eating bacterial infection, health
officials said on Thursday.
Lana Kuykendall, 36, was in critical but stable condition at
Greenville Memorial Hospital, hospital spokeswoman Sandy Dees
said.
Kuykendall, who gave birth to twins this month at a Georgia
hospital, came home to South Carolina and had severe pain in her
leg, her husband, Darren Kuykendall, told a local television
station. Within 15 minutes of noticing that the painful spot on
her leg was spreading, she went to the hospital, he said.
She underwent her fifth surgery to remove necrotic, or dead,
tissue from her lower leg after being hospitalized last Friday,
the hospital said in a statement.
“A team of surgeons, critical-care physicians and infection
disease specialists at Greenville Memorial Hospital continue to
very closely monitor and treat her condition,” the statement
said.
Kuykendall was diagnosed with necrotizing fasciitis, a
flesh-eating infection that can destroy muscles, skin and
tissue.
Necrotizing fasciitis is typically managed by surgery,
antibiotics and aggressive supportive care, the hospital
said. “She remains very ill but stable,” said Dr. Bill Kelly,
hospital epidemiologist for Greenville Hospital System.
Lana Kuykendall is a paramedic. Her husband, Darren, is a
firefighter.
“We’re extremely grateful for the extraordinary medical care
and the incredible community support we’ve received,” Darren
Kuykendall said.
THE WORST KIND
Dr. Jerry Gibson, an epidemiologist with the South Carolina
Department of Health and Environmental Control said she was on a
ventilator.
“She has the worst kind of bacterial infection,” Gibson told
Reuters. “It destroys tissues and invades the long membranes. We
see four or five cases a year in South Carolina. There’s no
prevention.”
Two other cases of flesh-eating infections have been
reported recently in South Carolina and Georgia. But Gibson
said, “These cases don’t cluster together except randomly.”
Different bacteria can cause necrotizing fasciitis. Gibson
said he had not seen Kuykendall’s medical chart and did not know
what type of bacteria was to blame. The hospital would not name
the underlying bacteria.
Necrotizing fasciitis can be caused by group-A streptococci
or by staphylococci, common bacteria that live on people’s skin
and in their noses, he said.
“Normally, they do nothing,” Gibson said. “Sometimes the
group-A strep causes strep throat. Sometimes the staph causes a
skin infection. Rarely, people can become infected in a place
that’s usually sterile – heart, lung, tissue under the skin –
and have group-A strep where it shouldn’t be.
HIGH MORTALITY RATE
“This is a condition that scares people,” he said. “Patients
are usually very normal and then they deteriorate fast. It
usually starts at the site of a break in the skin. People may
wash it out and it suddenly starts progressing.”
Gibson said he does not know if Kuykendall’s infection could
have started in the hospital where she gave birth.
“It started growing on her leg,” he said.
Necrotizing fasciitis has a high mortality rate. “It moves
so fast and often requires very invasive surgery to correct it,”
he said.
In another recent case, Georgia college student Aimee
Copeland, 24, was being treated for necrotizing fasciitis at
Doctors Hospital in Augusta, Georgia. She has had most of one
leg amputated and was expected to suffer the loss of her fingers
as well.
Copeland contracted the infection after a zip-line accident
in which she fell and cut her leg along the Little Tallapoosa
River near Carrollton, Georgia. Doctors blamed her infection on
the Aeromonas hydrophila bacteria, which are found in fresh or
brackish water.
A former South Carolina fire chief, Glenn Pace, told a local
television station he had been battling the disease since early
April, spent 20 days in the hospital and had three surgeries on
his foot but did not have to have his leg amputated.
The infection is caused by “something subtle, sometimes in a
person who has poor nutrition or alcohol use but also in people
who have no immune deficiencies,” Gibson said.
The “flesh-eating” infection is not communicable, he said.
(Editing by David Adams and Xavier Briand)
