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

In the murky world of rag sheet tabloida pertinata, I often share the pulpwith Oprah, Regis, Rosie, various aliens and my bud, Mad Cow. I am ...(drum rollplease) ... the "Flesh-Eating Disease! I'm really a simple thing, a gram +,beta-hemolytic, group A streptococcus (whatta GAS) familiar to folks as strepthroat or tonsillitis. On rare occasions, though, given just the right stuff, Ican 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 10to15 percent of available epidermi or pharynxia. Transmitted by droplets ordirect contact, show me the opening ... a wound, cut, crack, even a blunt traumasite ... and I'll show you supervirulence that'll digitize your dreams. I'vebeen around at least since 5th century B.C., when Hippocrates took time off fromoath-prep to describe my plasmic politics. I made an uncivil black-and-blueimpression on thousands of the U.S. blue-and-gray, and sporadically broke outseveral 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 signsare so typical, i.e., chills, fever, redness, swelling ... I'm usually notdiagnosed until it may be too late. Oh yeah, one of my signature signs is whatwe'll politely call "disproportionate" pain. Translation: I reallyhurt like a (insert expletive)!

If not treated aggressively, immediamento, I can kill within 24 hours. I'mabout 20 percent fatal if I do turn on you, logging 200 to 400 U.S. mortosannually. 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 anarsenal of antibiotics, along with "debridement" (use yourimagination) and oftentimes, amputation. HBO (hyperbaric oxygen, not cable TV)appears to be effective in countering O2 tissue deprivation, but those deliverychambers aren't exactly handy as ATMs.

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

The condition I cause translates to "death," which seems apt, allthings considered. For a subscription to The National Inquirer or a really nicegift, whichever is less likely to tempt a peek at the neighborhood checkoutstand, name my Strepto species (sounds like a Greek pastry chef) and theinvasive condition I present.

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