Freak Accident! (sorry kinda long)

Nurses General Nursing

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I was recently hospitalized and had three surgeries on my arm because of an infection that was supposedly caused by Chlostridia. It was such a freak accident, I just wanted to see if you guys had ever heard of anything like this.

I was attending a horse show in Michigan where I was showing a baby filly. I went to the fairgrounds on Saturday Oct. 11, and while I was going into the fillies stall, I barely poked myself on a smooth wire attached to the stall door. I thought absolutely nothing of it considering it didn't even draw blood and I continued to get the baby horse ready. I had no symptoms of an infection until I was home on Monday Oct. 12th. I woke up that morning and my arm was slightly swollen, but barely noticeable and I was having some shooting pains down my elbow throughout the day, there was also some weakness in the strength of my arm. I just figured I had slept on my arm funny or my arm was sore from showing the filly because they tend to jerk you around. By Monday night, the pain was still present but now the arm was puffy and very sore to the touch. My forearm was probably twice it's normal size and bright red. I then found an area around my elbow that was squishy and seemed to have subcutaneous air, it made a crackling noise much like styrofoam. I called my Dr. and made an appointment for the next morning to get my arm checked out. At the appointment, the Doc looked at it really quick and said it was just a case of Cellulitis and prescribed Augmentin. I got the prescription filled and then proceeded to vomit the antibiotics back up. I never ran a fever and I had taken the meds with food, so the Doc prescribes another medication. I go home that night and by bedtime, I no longer had a wrist or a hand, it had swelled and was in the same condition as my forearm. I decide to go to the ER in the morning and see if I could get IV antibiotics since the orals obviously had not improved the arm. It's now Wednesday the 15th and I go to the ER where I am placed in observation for 24 hrs on IV antibiotics. At 3:00 A.M, a resident comes in and says he would like to get some X-Rays, no problem. After reading the x-rays, the resident comes back to inform me that I will be going into emergency surgery. I get to surgery at about 5 A.M and am given all the talks about what would happen and so forth. After the operation, the surgeon tells me that I had Necrotic Fasciitis and if I had come to the hospital 12 hours later than I would have lost my arm from the shoulder down. To make this story a little shorter, I was in the hospital for 8 days and had another two surgeries after the first one. The surgeon believed that I would need a skin graft to close the incisions, but luckily it was not needed. I have an incision from my wrist to my elbow on the top and bottom of my arm and two incisions on my hand(over 200 stitches). The infectious disease Dr. said that the poke from the wire could have been the cause.

I am happy to be out of the hospital, I got out on the 23rd. I am now going to physical therapy and am hoping to be back to normal soon. Three of my fingers work and I have half of the normal ability in my wrist and am very hopeful for a full recovery.

My question to you is, have you ever heard of anything like this? and does the diagnosis of Chlostridia sound correct? This was such a freak accident, but it has not affected me much, I am still in high spirits and am calling myself the bride of Frankenstein. Thanks for reading all this, I tried to keep it as small as possible!:D

Specializes in Critical Care.

Just out of the money is never fun, but I think the more important thing for a young horse is the exposure. Standing well is a big plus considering a lot of the youngsters fidget. I think it's always fun messing with the colts/fillies b/c you're shaping there future careers by the experiences they're having now.

Glad you had a good time, glad you're on the road to recovery and I hope you're in the money next time.

Wow..glad you went in. The same thing happened to one of my aunts about 6 yrs ago but she "scratched " the outside of her hand on chicken coop wire. Ir is amazing how the wrong "bug" can do so much damage, isn't it? Anyways, glad everything turned out okay for you!! Erin

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

Hope you continue to get well. Sounds awful.

There was recently an article in the paper how a sponge diver recently nicked his leg in the water and it grew into a wicked infection. There are some heavy duty bugs out there. A little nick can turn into something very nasty these days.

We're studying Clostridium in Microbiology right now.

It's an anaerobic bacteria - notoriously difficult to grow in the lab, which might be why your cultures didn't show anything. Clostridium is a particularly nasty family of bacteria.

C. perfingens causes gas gangrene.

C. botulini causes botulism

C. anthracis causes anthrax

Since it's an anaerobic bacteria, it can't grow in the presence of oxygen. That's why it's often treated by placing the patient in a hyperbaric chamber - all that oxygen kills it off.

Hope that helps a little. And I hope that you feel better very soon.

-t

There was discussion of putting me in the hyperbaric chamber, they decided against it since we seemed to be getting ahead of the infection and they would of had to transfer me to another hospital.

I'm so glad that everything worked out for you...Someone had His eye on you for sure! Scary stuff...when you think it's something so innocent...

Amanda :)

Specializes in ER!.
Originally posted by TheMagicCookie

Well, she would have done a lot better, but she hurt herself in the trailer on the way down and she was off when she was trotting. She stood up really nice, but that's only 50% of the overall judging. It was a jackpot class and it paid money to the 5th place, she got 6th. I had fun anyways.

Now that your infection is cleared up, I'm interested in your horses. :D What do you show? I've got a 3 year old that needs some direction in his life, so I'm always interested in what others are doing with their youngsters. Yours did pretty good, considering that she'd hurt herself, and having fun seems to me to be the best reason to get into this in the first place. Congratulations!

Glad to hear you are doing better... that is scary.

I have seen necrotizing fascitis once... it was awful... the poor man got it on his scrotum!!!!!!!!!!!!!!!!!!!

I am inclined to think the no-growth on the cultures is due to the antibiotics. A very small colony of bacteria can produce a huge amount of toxin and that toxin is not affected by the antibiotic. Once necrosis starts it can really be a slippery slope with the dying cells putting of substances that "poison" surrounding healthy cells.

I am they got the infection before it cost your arm, or worse, your life. I hope the rest of your healing goes well.

My Mom's cat bit her on her shin, it seemed to be healing well at 5 days old it went south in 12 hours (NF). We were 12 more hours and she would have lost the leg, 24 and it would have been her life. BTW, surgeon wanted to do a skin graft on the large (3" diam) wound left by surgical debridement, he insisted it would *never* heal and for her to plan on being admitted for grafting when she came to her 2 week folllow up. Ahh the miracle of NS wet to moist dressings...at the 2 week check it was 50% smaller and the remaining open area was heavily granulated. She didn't get the graft.

Now that your infection is cleared up, I'm interested in your horses. What do you show? I've got a 3 year old that needs some direction in his life, so I'm always interested in what others are doing with their youngsters. Yours did pretty good, considering that she'd hurt herself, and having fun seems to me to be the best reason to get into this in the first place. Congratulations!

I show American Saddlebreds. I have been around them for about 6 years and have loved every minute of it, the energy the possess is so amazing. I have two geldings, The Magic Cookie(hense my user name) and The Wanted(he's new and I might change his name to something more interesting). I've shown Saddleseat equitation and show my older horse, The Magic Cookie in Country Pleasure. I am planning on showing The Wanted in Show pleasure. What kind of horse do you have?

My Mom's cat bit her on her shin, it seemed to be healing well at 5 days old it went south in 12 hours (NF). We were 12 more hours and she would have lost the leg, 24 and it would have been her life. BTW, surgeon wanted to do a skin graft on the large (3" diam) wound left by surgical debridement, he insisted it would *never* heal and for her to plan on being admitted for grafting when she came to her 2 week folllow up. Ahh the miracle of NS wet to moist dressings...at the 2 week check it was 50% smaller and the remaining open area was heavily granulated. She didn't get the graft.

Wow that doesn't sound like much fun at all, I'm glad she pulled through!:D

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