Athlete Undergoes Surgery to Save Germ-Ravaged Leg
Triathlete Bernard Donner underwent surgery Friday morning to save his left leg from the ravages of the so-called “flesh-eating bacteria,” which apparently entered his body through a shaving cut as he bicycled near his Santa Barbara home Sunday.
Donner remained in critical condition, but his doctors are encouraged that the infection has not spread beyond the leg, said Dr. A. Richard Grossman, medical director of the Sherman Oaks Hospital burn center.
In a news conference, Grossman also sought to allay the public’s fears of the infection, known as “necrotizing fasciitis.” News reports of seven cases in Gloucestershire, England, this spring sparked a media frenzy. Twelve deaths from the infection were reported across England, and international researchers say that incidence of the disease, which was more common before the development of antibiotics but had almost disappeared by the 1970s, has been increasing.
Grossman noted, however, that he has treated only four cases of the infection since 1992, and said it is still too rare to justify public alarm in the Los Angeles area. “If you were out on the golf course and got struck by lightning, that’s about how frequently this occurs,” he said.
Grossman said he and Dr. Michel Brones, another burn center surgeon, had temporarily covered an infection-related opening on Donner’s left thigh about 12 inches long and six inches wide with cadaver skin, a practice also used in treating burn victims. The doctors hope to begin replacing the cadaver skin with Donner’s own skin next week.
Necrotizing fasciitis is a rare and especially aggressive manifestation of the Group A streptococcus bacterium that causes the common and usually harmless strep throat. Since Donner felt the first pains Sunday night, the infection has destroyed half the muscle tissue in his left leg, Grossman said.
Although Donner remains in critical condition, Grossman said the infection has not spread. “At this point we’re treating him like any other burn patient,” he said. “I’m encouraged today, but we’re not going to be out of the woods until he walks out of here. However, we hope to be having him walking with crutches in two to three weeks.”
Until his next round of skin grafts, Donner will spend much of his time in Sherman Oaks Hospital’s hyperbaric chamber, which promotes healing by forcing pressurized oxygen into the blood. Donner, who was first treated at Cottage Hospital in Santa Barbara, was transported to Sherman Oaks Hospital on Wednesday because it is one of only eight hospitals in Southern California that has such a chamber.
The hospital is setting up a trust fund to help pay Donner’s $4,000-a-day medical bills and the cost of his rehabilitation, since his insurance plan pays only $300 a day, Grossman said.
A longtime Santa Barbara lifeguard and swim camp counselor, Donner also ran, bicycled and swam in triathlons, a demanding event that usually covers a course of 32 miles. With rehabilitation, Grossman said, “I believe he’ll go back and try and run again.”
Statistics on the incidence of the tissue-destroying infection in the United States are unreliable because only about 22 states require doctors to report all invasive Group A strep infections--of which necrotizing fasciitis is only one. It occurs when the infection enters and begins to rapid devour the fascia, the tissue that binds skin to muscles, health officials say.
The federal Centers for Disease Control and Prevention estimates that in 1990, the last year for which statistics are available, there were 500 to 1,500 American cases of necrotizing fasciitis.
“From that, you can extrapolate that about 10% of those were in California,” said Scott Lewis, a spokesman for the California Department of Health Services.
“This infection has been known for years,” he said. “We’ve known it’s been occurring for years. We’ve also had experience with what we call media clusters. It’s always out there, (but) suddenly every case becomes a big deal because the media does a story on it.”
Dr. Carol L. Peterson, a medical epidemiologist for the Los Angeles County Health Department, said authorities had received reports of “approximately four” cases of necrotizing fasciitis in the county so far this year.
She could not say how that figure compared to last year. “We don’t keep track of it that way,” Peterson said, explaining that the department also asks doctors to report other kinds of Group A strep.
“The numbers (of necrotizing fasciitis cases) we have are extremely small,” Peterson said. “We don’t think the public needs to be frightened by this entity at this time. We are concerned about invasive Group A strep diseases and we’re looking at this issue, but the data is not complete.”
