Infection Control Today - 04/2003: Microbe of the Month

Microbe of the Month
By Roger P. Freeman, DDS

In the murky world of rag sheet tabloida pertinata, I often share the pulp with Oprah, Regis, Rosie, various aliens and my bud, Mad Cow. I am ...(drum roll please) ... the "Flesh-Eating Disease! I'm really a simple thing, a gram +, beta-hemolytic, group A streptococcus (whatta GAS) familiar to folks as strep throat or tonsillitis. On rare occasions, though, given just the right stuff, I can turn "invasive" and literally scorch your socks off.

Like I said, I'm a pretty regular guy most of the time, residing in or on 10 to15 percent of available epidermi or pharynxia. Transmitted by droplets or direct contact, show me the opening ... a wound, cut, crack, even a blunt trauma site ... and I'll show you supervirulence that'll digitize your dreams. I've been around at least since 5th century B.C., when Hippocrates took time off from oath-prep to describe my plasmic politics. I made an uncivil black-and-blue impression on thousands of the U.S. blue-and-gray, and sporadically broke out several times in the late 20th century.

I actually work by trickling out toxins that dissolve fat 'n fascia sub-cu, all the while munching nutrients from the leftovers of my carnage. Early signs are so typical, i.e., chills, fever, redness, swelling ... I'm usually not diagnosed until it may be too late. Oh yeah, one of my signature signs is what we'll politely call "disproportionate" pain. Translation: I really hurt like a (insert expletive)!

If not treated aggressively, immediamento, I can kill within 24 hours. I'm about 20 percent fatal if I do turn on you, logging 200 to 400 U.S. mortos annually. Sorry, I'm afraid I was the one responsible for the Main Muppet Man. I'm sensitive to penicillin, but only if treated early; otherwise, it'll take an arsenal of antibiotics, along with "debridement" (use your imagination) and oftentimes, amputation. HBO (hyperbaric oxygen, not cable TV) appears to be effective in countering O2 tissue deprivation, but those delivery chambers aren't exactly handy as ATMs.

I'm predisposed to the immune-comped, diabetics, alcoholics, AIDS patients and chicken poxers. But, hey, the good news is that contrary to that Internet hoax-o-rama, I am not associated with Costa Rican bananas!

The condition I cause translates to "death," which seems apt, all things considered. For a subscription to The National Inquirer or a really nice gift, whichever is less likely to tempt a peek at the neighborhood checkout stand, name my Strepto species (sounds like a Greek pastry chef) and the invasive condition I present.

Roger P. Freeman, DDS, is a dental infection control consultant and president of Infectious Awareables at The answers to last month's mystery microbe are: Vaccinia virus and vaccination.

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