Necrotizing Fasciitis from a PAPER CUT

[anticoagulationurse]

Scary! I have a patient who had a normal little paper cut. She worked in a medical records department. Two weeks later her arm was being eaten alive from the inside out by necrotizing fasciitis (flesh eating bacteria). Yikes! (She had a fasciotomy and is fine now).

[cleverusername]

I recently had a patient who got necrotizing fasciitis from popping a zit on her butt.

[totally_nuts]

OMG that's a little scary!!

[TDCHIM]

Considering that I'm heading for some sort of HIM department after I graduate, this is a thread guaranteed to give me nightmares! Good lord, how awful!

[nurse2033, MSN, RN]

I recently had a patient who got necrotizing fasciitis from popping a zit on her butt.

I've seen a few cases all involving the groin area. Take a bath!

[Anisettes, BSN, RN]

I've seen a few cases all involving the groin area. Take a bath!

It's not a question of bathing or not bathing. It's a simple as the right (or wrong, as it were) bacterium entering through a break in the skin, even a scratch offers an opening. You can wash your hands and 2 seconds later cut or scratch yourself with something coated in said bacteria and there you go. You're covered in organisms at all times (even fresh from the shower), living things can't be sterilized.

[nminodob]

Anecdotal, I know, but...all our pts with nec fasc have been IV drug abusers. Not sure how far this type of infection would get in a healthy person with no co-morbidities. I would think it is similar to C diff - we have dozens of pts that have it, yet I can"t remember too many of the nurses caring for them missing work d/t C diff infection.

[kesr]

Crap - a friend had it from scraping her elbow on patio furniture. Such a small scrape, didn't even need a bandaid!

[goats'r'us, ASN, RN]

It's not a question of bathing or not bathing. It's a simple as the right (or wrong, as it were) bacterium entering through a break in the skin, even a scratch offers an opening. You can wash your hands and 2 seconds later cut or scratch yourself with something coated in said bacteria and there you go. You're covered in organisms at all times (even fresh from the shower), living things can't be sterilized.

You're quite right, but so is Nurse2033. it's true you can be al pink and scrubbed clean but still develop NF from an unfortunate scratch from something contaminated, but you can just as easily develop it from your own manky groin bacteria (or just perfectly normal skin flora) getting in through a break in the skin.

moral of the story, if you gently scrub every inch of your perfectly intact skin with glen 20, and never ever touch anything at all (including yourself), the NF will never get you.

unless you get bitten by a white-tailed spider...

[elkpark]

Yep, it's all about breaks in the skin and what bacteria is "in the neighborhood." In nursing school, I helped care (in the ICU) for a man who ultimately died of classic, old school gas gangrene (you know, like from WWI) -- he was diabetic and was exposed after clipping his toenails (and breaking the skin in the process). When I first encountered him (my ICU rotation was 3 months long), he had already had a BKA which, unfortunately, had not gotten all the infection -- he went on to have an AKA and a hip disarticulation, as the infection continued to travel up his leg, during the time I knew him; in each case, the amputation failed to get all the infection, it got into his abdomen, and he finally died.

Ever since then, I've been a big believer in all the cautions about clipping diabetics' toenails.

[goats'r'us, ASN, RN]

Ever since then, I've been a big believer in all the cautions about clipping diabetics' toenails.

ugh, that's enough to make me nervy about clipping MY OWN toenails!

Poor man, must have been a hard way to go

[goats'r'us, ASN, RN]

it's amazing to think that I can have my whole hand in your chest ( I work in the OT, I don't just plunge my hands into chests for ***** and giggles) with no ill effects, but a patio scrape or a bit of home podiatry can kill you.