An 8-year-old Oregon boy died days after doctors amputated most of his limbs in a desperate bid to halt the progression of deadly flesh-eating bacteria.
Liam Flanagan, a second-grader from Spring Creek, contracted the flesh-eating bacteria after crashing his bike while riding down a hill near his family home on Saturday Jan. 13.
Liam suffered a gash in his groin area that required stitches to close. Several days later, he complained of excruciating pain in his leg. His mother Sara Hebard and stepfather Scott Hinkle examined the area and were shocked to see an inflamed growth on his groin.
Scott said he couldn't believe his eyes. "It was purplish-red and gangrenous looking," he told a reporter. 'We threw him in the rig and went like hell."
Liam was admitted to St. Anthony Hospital where doctors diagnosed him with necrotizing fasciitis, a deadly bacterial infection caused by common bacteria normally found in soil (Streptococcus, E-coli, Staphylococcus, Klebsiella, etc.).
Dotors spent hours cutting away flesh to remove the dead skin (debridement) and Liam was given intravenous antibiotics to kill the bacteria.
The bacteria enters the body through a break in the skin then spreads quickly, burrowing under the skin and flesh and feeding voraciously on the fascia, the thin fibrous lining covering the muscle and nerves.
The bacteria reproduces quickly and moves like wildfire. It is a race against time for doctors to save the victims.
Death can occur in 3 days if the infection is not halted. Often doctors are forced to cut away pounds of flesh and muscle to stop the infection.
Running out of options, doctors transferred Liam to Doernbecher Children's Hospital in Portland early Thursday morning, and Sara followed him there. Scott stayed behind to care for their other sons at home.
At the hospital, doctors cut away more flesh and muscle from the bone as the infection spread down Liam's right leg. Eventually the decision was made to amputate his right leg and then his right arm as the infection spread.
"They basically cut him up piece by piece," Scott said.
"Almost his whole right side was gone," Sara said. "They kept cutting and hoping. Cutting and hoping."
Scott said he last spoke with Liam by phone on Friday.
"I told him to be strong and that he'd be OK," Scott said. "He said he missed me."
On Sunday, Liam was transferred to a 3rd hospital, Randall Children's Hospital, also in Portland.
He died hours later.
Liam's distraught parents wonder if they had listened to their son earlier and taken him back to the hospital when he complained of pain, they might have saved him.
They thought his pain and discomfort was a normal part of the healing process.
Necrotizing fasciitis affects 0.4 to 1 person per 100,000 per year. Both sexes are affected equally but the disease is more common among Caucasians.
Signs and symptoms
Symptoms begin within hours of infection and progressively worsens if not treated quickly. In the early stages, the skin is red and swollen. As the infection spreads the skin becomes purple and black -- a sign of necrosis (flesh death).
Diagnostic tests include blood work, Computed tomography (CT scan), and MRI.
The disease can be prevented by washing with soap and water and giving good wound care immediately after the skin is broken.
Surgical debridement (cutting away affected tissue) and intravenous antibiotics (piperacillin/tazobactam, vancomycin, and clindamycin), and Hyperbaric oxygen chamber.
This has been your Medical Minute.
More Info On the Web
Necrotizing Fasciitis - CDC
Necrotizing Fasciitis - Medscape
Is Necrotizing Fasciitis Infectious? eMedicine Health
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