January 28, 1995 in Nation/World

Idaho Boy With Chickenpox Contracts Flesh-Destroying Bacteria 4-Year-Old Recovering From Surgery To Remove Part Of His Thigh

By The Spokesman-Review
 
Tags:disease

A 4-year-old Idaho boy with chickenpox has contracted the flesh-destroying bacteria that hospitalized nine other children in Seattle during the past year.

The boy was flown from a Spokane hospital to Children’s Hospital and Medical Center in Seattle, where he was recovering Friday from surgery to remove part of his thigh.

Although the bacterial infection, similar to gangrene, is rare, doctors are urging parents to keep a close watch on children with chickenpox.

“We do know that we’ve got a bad-acting (infection) in the Northwest right now. They come in bunches that way,” said Russell Alexander, chief epidemiologist with the Seattle-King County Department of Public Health.

So far, all children with the flesh-destroying infection - called nectrotizing fasciitis - have had chickenpox first.

“It’s a very rare complication of a common disease. Once it gets going, it can move very quickly and the mortality is high,” Alexander said.

Seattle doctors say people close to the infected children haven’t contracted the illness.

About a third of those with nectrotizing fasciitis die as toxins kill the tissue that binds skin to muscle. None of the Seattle children has died.

Seattle doctors are also advising parents not to give ibuprofen to children with chickenpox, because it may make infections worse.

Some children hospitalized in Seattle with the infection - dubbed “flesh-eating bacteria” by tabloids - have suffered disfiguring wounds, said Alexander.

Eight of the children took ibuprofen while they had chickenpox.

However, physicians have long recommended against giving children aspirin for chickenpox or influenza. Use of aspirin with those diseases has been linked to Reye’s syndrome, a rare, potentially fatal illness.

The Idaho boy’s parents asked doctors not to release details about his ordeal or hometown.

“He’s stable, and we anticipate he’ll do well,” said David Jardine, the boy’s doctor at Children’s Hospital.

The boy was flown to Seattle on Thursday after 10 days at Sacred Heart Medical Center in Spokane, where he was admitted with chickenpox and a leg infection, authorities said.

Surgeons removed infected tissue from his left thigh late Thursday night, said hospital spokesman Dean Forbes.

He also spent time in a hyperbaric oxygen chamber, which doctors believe may help stop the infection.

Spokane doctors didn’t know whether the boy had taken ibuprofen.

The fast-acting bacteria is a strain of a common germ, Group A streptococcus. Until two years ago, it was relatively easy to treat with antibiotics, said Jardine. But instead of merely causing strep throat, this version is extremely aggressive.

“Probably the biology of this strep has changed over the last few years so it’s less responsive to the therapies we’ve always used to treat it,” Jardine said. “It’s much stronger.”

Chickenpox lesions are a means of entry for the infection, he said. “The thing we don’t understand is what else it takes” to contract it.

The children treated at Children’s Hospital and Medical Center have lost tissue from their chest and limbs. In other areas, people have lost flesh from their faces as well.

“We have seen kids lose a fair amount of tissue from a limb,” said Jardine. “For the most part, it seems to travel underneath the skin in connective tissue.”

Surgeons remove decaying tissue and clean around it. The wound initially is left open and monitored, then surgically closed later. Plastic surgery sometimes follows.

Shirley Thompson, a nurse at the Spokane County Health District, said the Idaho case is the first reported in the area.

Parents should watch for chickenpox lesions that become inflamed and painful and listen for complaints of aching limbs.

They should also trim the fingernails of children with chickenpox and urge them not to scratch the itchy sores.

“If the lesions become infected and red and hot, that’s not OK,” Thompson said. “That’s a red flag and it needs to be attended to.”

The chickenpox season lasts into the spring.

xxxx What is it? The flesh-destroying infection is caused by bacteria that can attack the body through chickenpox sores.


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