Last month, a few minor blisters turned into a flesh-eating nightmare for hiker Wayne Atkins, who developed a dangerous bacterial infection after climbing Mount Garfield, a 4,500-foot peak in New Hampshire. Atkins survived, but barely: He spent 2 1/2 weeks in a medically induced coma while doctors pumped him full of antibiotics and removed chunks of his flesh to get rid of the infection.

And Atkins was lucky, relatively speaking: Infection with flesh-eating bacteria is considered a surgical emergency, and can require limb amputation. One in four people with necrotizing fasciitis dies.

But is there any reason for the rest of us to be concerned? Or was Atkins’s case a bacterial lightning strike?

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Here are five things to know about flesh-eating infections:

1. What causes the infection?

Multiple types of bacteria can cause so-called flesh-eating infections, also known as necrotizing fasciitis, but Atkins fell victim to Group A Streptococcus, which Dr. Bernard Camins, an infectious disease specialist at the University of Alabama at Birmingham, considers “the quintessential flesh-eating bacteria.”

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Group A strep may sound familiar: It is the same bacteria that causes strep throat.

2. Where does a person catch that bacteria?

Around 3 percent of healthy adults and 5 to 15 percent of healthy children have Group A strep bacteria colonies in their nose and throat or on their skin. When people develop necrotizing fasciitis, it’s usually because Group A strep already on their skin get inside a wound after an injury or surgery, though a needle prick or blister could be enough. From there, the bacteria quickly start destroying skin, fat and muscle, and eventually work their way into the bloodstream.

3. Why does a generally harmless bacteria turn deadly?

According to Camins, Group A strep bacteria are very unpredictable, and scientists don’t know for sure. They can turn deadly once they breach the body’s natural barriers and reach the superficial fascia, a layer of connective tissue just underneath the skin. From there, they start spreading rapidly into the surrounding tissues, releasing destructive toxins along the way.

This is more common in people with weakened immune systems whose bodies can’t fight off the bacteria as effectively. The Centers for Disease Control and Prevention estimates that only 700 to 1,100 cases of necrotizing fasciitis occur every year in the U.S., and most occur in people with diabetes, kidney disease, cancer, or other conditions that weaken the immune system.

4. What are the symptoms?

A necrotizing fasciitis infection can develop within a few hours, and is difficult to diagnose, especially early on when patients may have vague symptoms, such as pain or soreness at the injury site. Early symptoms can also include reddish or purplish areas of swelling that spread rapidly, and Camins said one giveaway is when people have “pain that is out of proportion to what the wound looks like.” Later symptoms include fever, chills, or vomiting. Doctors generally treat the infection with a combination of strong antibiotics to knock out the bacteria and surgery to remove dead tissue.

5. How can I avoid it?

To avoid infection, Camins recommends washing wounds with soap and water, applying antibacterial ointment like Polysporin, and checking wounds on a regular basis. And if you are in huge amounts of pain from a wound that otherwise looks OK, get yourself to a hospital ASAP.

  • My uncle wasn’t feeling well 1/9/2020 so he saw his doctor on 1/10/2020. During his exam he tells the doctor that he also has an ingrown hair in his upper thigh that’s killing him. His doctor told him to go to the emergency room, so he did. He had surgery that evening and again Sunday morning, to remove black and dead material. The infection worked its way up into his groin and scrotum. He’s still in the hospital right now. He was also told that recovery might take up to 6 months and he might have to go to a recovery facility at first. He’s likely going to lose his only source of income. We don’t know at this point if he has short term disability so he will probably have to lean on social security and live with my mom. We’ll probably move his RV (house) onto my property. For him, it’s the perfect storm. His RV is unclean. His circulation is bad and he has diabetes. All of this together, made him a perfect candidate for necrotizing faciitis. Listen to your body and take care of yourself. It’s the only one you have. One thing can lead to another. Scary stuff.

  • How can dermatologists distinguish the difference between eczema and psoriasis unless they do a biopsy’ and how likely can a misdiagnosis occur?

  • I had an accident and a wheelbarrow fell on me,l landed on grass!it is still very sore after three weeks and it itches as well, above that is a bruise I have had for eight weeks and is still full of fluid,my ankle and foot is also swollen and my leg feels hot,beento doc twice and he gave me an elastic stocking and told me to rest with my leg elevated. I am sixty four could this be the reason it it taking so long to heal.thank you

    • Michelle; I am not a doctor, however, I always research and search though I ask members of my family who are, and when my mind speaks, I go for a second or third opinion. And, you know, couple of times, its paid off. I am not saying this may be the reason you are in such situation, but it would be wise to get a second opinion, specially after several weeks. you are 6’ 4” Wow, great. I am 5’ 8” and feel like 6’ 4” myself 🙂

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