Thursday, May 10, 2012

Necrotizing Fasciitis

Pediatric Cervicofacial Necrotizing Fasciitis
Hilton Head Man Survives Deadly Flesh Eating Infection
Aimee Copeland "very responsive," but to lose hands and other foot to necrotizing fasciitis, says report

Pediatric Cervicofacial Necrotizing Fasciitis

Ericka King, MD; Robert Chun, MD; Cecille Sulman, MD

Arch Otolaryngol Head Neck Surg. 2012;138(4):372-375. doi:10.1001/archoto.2012.119

Objective To present a case of a pediatric cervicofacial necrotizing fasciitis (NF), a rapidly progressive infection, and a review of a 10-year pediatric inpatient database.

Design Case report and review.

Setting Pediatric intensive care unit.

Patients A healthy 5-year-old male who developed NF of the lower lip 36 hours following minor trauma. International Classification of Diseases, Ninth Revision, code 728.86 (NF), was the inclusion criteria for the Kids' Inpatient Database (KID) in 1997 and 2006.

Results A pediatric case is presented with a thorough photographic record demonstrating the need for rapid diagnosis and treatment. In a review of the KID from 1997 and 2006, the relative risk of being discharged with NF in 2006 vs 1997 was 1.4 (95% CI, 9.95-2.28). Age at diagnosis of NF was older in 2006 compared with 1997 (11.5 years vs 8.05 years; P < .001). Deaths with a diagnosis of NF increased from 1997 compared with 2006: from 3.9% to 5.4%. In 2006, the odds of death were 15.1 times higher in pediatric discharges with a diagnosis of NF compared with discharges without a diagnosis of NF (P < .001; 95% CI, 9.3-23.1). Conclusions Even with the advent of new treatments and antibiotics, the incidence and death rates of NF have changed little over the past 10 years. While it is still a rare diagnosis, knowledge and awareness of necrotizing fasciitis with aggressive medical and surgical treatment are still the foundation in disease survival. Author Affiliations: Department of Pediatric Otolaryngology, University of Michigan, Ann Arbor (Dr King); and Department of Otolaryngology, Medical College of Wisconsin, Milwaukee (Drs Chun and Sulman). Hilton Head Man Survives Deadly Flesh Eating Infection

By: Meredith Ley | WSAV TV 3
Published: May 10, 2012


It’s a bacterial infection that attacks soft tissue and destroys muscle.

It’s very rare, but what is known about it is that it often leads to amputation and even death.

Because of it, a young Georgia woman is fighting for her life at an Augusta hospital.

She is losing her hands and a foot-- after contracting it from a cut.

While she is listed in extremely critical condition, a Hilton Head man says there is hope she can make it. He should know -- he survived it himself.

"I had breakfast with a friend one morning, and told him I wasn't feeling well.”

But Barry Ginn had no idea just how bad he would feel.

On February 24th, he had severe pain and a fever in his shoulder.

Thinking it was a torn rotator cuff, he went to his regular doctor, but instead it was an infection called Necrotizing Fasciitis and it was eating Ginn alive.

"They gave me a twenty percent chance of survival. Some people say I was the sickest person at The Medical University of South Carolina for 72 hours."

In order to save him, a team of three doctors removed most of Ginn's upper shoulder and arm.

He underwent nine surgeries in just four days.

No one was really sure if he was going to make it. But now, he is on the mend.

"My heart goes out to the Copeland family because I know what they are going through. I was the lucky one out of the whole bunch because I wasn’t awake to see all the pain and suffering my friends and family were going through."

Ginn lives and loves like every day is his last. He says it's only because of the angels around him, he gets that chance.

“People were praying for me. I really hope that everyone that was here for me will now turn their attention to this girl in Augusta. She needs it."

While he can’t directly help her, he can send a message to others in hopes of raising awareness.

"If you have something and you don't know what is going on, you better get to a hospital and you better get to a good one."

Ginn's wounds were so severe; his doctors say it could take up to a year to heal. What causes the infection is still a medical mystery.

Aimee Copeland "very responsive," but to lose hands and other foot to necrotizing fasciitis, says report
Ryan Jaslow

(CBS News) Aimee Copeland, the 24-year-old graduate student who is fighting for her life against the flesh-eating disease necrotizing fasciitis is very responsive and coherent, according to a blog posted on a University of West Georgia Psychology department student website.

Aimee Copeland, 24, battles flesh-eating necrotizing fasciitis following zip-lining accident

In a post written Thursday afternoon, Aimee's classmate Ken Lewis provided an update for those following the tragic story, saying Aimee unfortunately will need her hands and her remaining foot amputated because the blood vessels have died.

Last week doctors had performed a hip-high amputation on Aimee's left leg. Not all the news was bleak, with Lewis writing that Aimee is responding to specific commands and has even selected the music she wants to hear.

"The neurologist says that there is no indication of any brain damage," Lewis wrote. "The cardiopulmonologist says that her lungs are slowly healing."

Aimee's sister Paige also wrote an update today on the Facebook page their father had set to raise awareness about Aimee's condition.

"Seeing Aimee this morning was so refreshing," Paige wrote Thursday afternoon. "Her eyes are wide open and she is nodding or shaking her head to the questions we ask. My hope for her recovery is stronger than ever!"

According to the Atlanta Journal-Constitution, a "Love Aimee" vigil is being held tonight at the University of West Georgia campus. Blood donations are also being accepted at the JMS Burn Center in Augusta where she has been hospitalized since last Friday.

Last Friday, emergency room doctors at Tanner Medical Center in Carrollton, Ga., diagnosed Copeland with necrotizing fasciitis. According to the Journal-Constitution, Copeland received a nasty cut on her leg last Tuesday on a homemade zip line she was using that broke as she and her friends kayaked along the Little Tallapoosa River in Carrollton.

Doctors closed the gash with 22 staples, but her conditioned worsened over the next few days until she was eventually hospitalized and diagnosed with the disease. The paper reports the bacteria that caused the disease was Aeromonas hydrophila, which is typically found in freshwater.

Symptoms of necrotizing fasciitis include a small red painful lump or bump in the skin that changes to a very painful rapidly growing bruise (sometimes within an hour), and the center of the bruise may become black and die, or break open and ooze fluid. Other symptoms include fever, sweating, chills, nausea, dizziness and shock. Immediate treatment, such as with powerful IV antibiotics or surgery is necessary to prevent death.

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