A Wisconsin woman nearly loses her leg, and her life, to MRSA.
"I would at the very least have a sizable area of my inner knee removed with the possibility of losing my leg. The worst case was that I could become septic from the infection and die."
Like many mothers who are consumed with raising two young children, I rarely think about coming in contact with potentially life threatening bacteria. Little did I know that the first six months of 2005 would have me fighting for my life and leave me permanently scarred.
It all began quite simply and was really nothing that anyone was alarmed about. While driving home from visiting family in Atlanta over Thanksgiving, I developed a boil on my backside. I had never had one before, and it was quickly becoming painful to even sit. I had to make a trip to my primary care physician for a routine exam anyway, so as part of the exam I asked her to evaluate the boil. She decided to lance it to aid in draining and relieve the pressure, which had become quite painful. She put me on an antibiotic to make sure that I didn’t get an infection. Over the course of the next couple weeks, the site began to heal, and neither my husband nor I thought much about it.
On Sunday, Dec. 27, I was sitting on the couch enjoying the days between Christmas and New Years with my family when I felt what I thought was a normal itch on my knee. I scratched the area hard enough to break the skin, and the next morning the site was inflamed, much like what had been on my backside. I didn’t want to take any chances, so I made a doctor’s appointment. The doctor prescribed another dose of antibiotics and scheduled a follow-up visit on Wednesday. When I arrived on Wednesday morning, the area had become further inflamed and hot to the touch. They had me take an IV antibiotic while I was in their office and follow up the next day.
On Thursday, things took a turn for the worse, with the redness still present and getting worse. The doctor immediately sent me to see the surgeon on call, who lanced it and informed me that it was a serious infection that he would have cultured. The culture came back positive for methicillin-resistant Staphylococcus aureus (MRSA).
Over the weekend things didn’t improve, and by Tuesday I developed red areas around the site, but thought it was irritation from the constant changing of the tape on the wound dressing. By late Wednesday evening the red sores were beginning to develop white blisters, and I was experiencing deep bone pain. I went to see the surgeon on Thursday morning and was in for the shock of my life! He took a look and was immediately alarmed that I had developed flesh-eating bacteria (necrotizing fascitis), and I would have to have emergency surgery to hopefully save my leg AND my life! The prognosis was not good, and even with the surgery I would be on high doses of vancomycin. My surgeon conveyed that this drug was virtually the last resort for the infection.
The outcome was grim at best. I would at the very least have a sizable area of my inner knee removed with the possibility of losing my leg. The worst case was that I could become septic from the infection and die. The anxiety and fear was tremendous. I called my husband and tried my best to tell him what was happening but couldn’t get it out over the tears. The surgeon took the phone and told him how serious the infection was and to get to the hospital as quickly as possible.
Before the surgery, I had a bone scan to determine if the infection had spread into the bones. Fortunately, there was no evidence of the spreading, but we really wouldn’t know until I went under the knife. What a horrible feeling of not knowing. Only a few weeks before, I had been in good health and more concerned with my children’s colds. Certainly, the prospect of losing my leg had never occurred to me.
By the time the surgery was over, I had a 19 square centimeter area about 2 inches deep of soft tissue removed from the inner side of my knee. The excavation of tissue went all the way to the muscle. It could have been worse, but I was going to have to endure the most painful experiences of my life as the wound was changed daily to remove the dead tissue. The wound had to be checked for any negative changes that would indicate the surgery had not successfully removed all the infection. I had these twice-a-day changes for a week before I finally had a skin graft to close the wound. Once the graft was completed, I was released and put on intravenous vancomycin.
My ordeal was far from over. It was only after I insisted on a consult with an infectious disease specialist that I began to see any progress. I learned what MRSA was, how it developed over time, and the few options that are currently available to treat the infection. I was taught the importance of simple hygiene, and while we practiced it, we would need to be very aggressive in preventing further infection to my wound or other family members. Most alarmingly, the infection that I had developed couldn’t be traced to common sources such as a gymnasium, hospital stay, or other known sources. I had developed what is known as a community-acquired strain, making in difficult, if not impossible, to determine the source.
Over the next two months, I had a host of complications slowing my recovery and further threatening my health. I developed blood clots from the lack of mobility and resistance to the vancomycin. Tests showed that even though we were highly conscious of hygiene, the bacteria remained on my skin and in the wound. I developed blisters on my belly that were likely the result of the same bacteria being introduced through injections to prevent the blood clots. This landed me in the ICU but fortunately no surgery was required this time!
It took months of physical therapy to regain the mobility and strength in my leg. Two years later, I have little feeling in the knee area or the lower leg from the damage done to the nerves. I know I am one of the fortunate ones who survived this escalating health threat. I am always fearful of the slightest cut. I know that my options for treatment are slim at best should the infection ever present itself again.
Posted: September 2007
Note: Interviews with Dee Dee Wallace can be arranged through the IDSA communications staff.
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