Baby Battling Flesh-Eating Bacteria Improves

An 11-month-old Oxnard girl fought for life in a pediatric intensive care unit in Northridge on Tuesday, her body ravaged by flesh-eating bacteria.

After removing strips of dead tissue from her chest and back, surgeons began grafting cadaver skin to her tiny frame Tuesday afternoon in hopes of staving off the deadly infection.

“This is a tragedy,” said plastic surgeon Stephen Bresnick, the pediatric specialist leading the surgical team at Northridge Hospital Medical Center. “This child has lost 20% of her skin. She’s lost muscle. She’s lost fat. Her ribs are exposed.”

The girl, identified only as Baby Rosa, was initially diagnosed and treated at Ventura County Medical Center on Thursday. She was transferred the next day to Northridge for treatment in the hyperbaric chamber, an oxygen-rich unit that stimulates the body’s immune system and accelerates healing.

Rosa remained on life support and massive doses of antibiotics Tuesday. She was listed in critical but stable condition. Doctors said she was improving, but cautioned that only about half the patients with such severe cases of flesh-eating bacteria survive.

Rosa’s parents have no health insurance, but Northridge Hospital has committed to continuing her treatment for months, if necessary, Northridge spokeswoman Toshia D. Johnson said. Already the medical costs total more than $100,000 at Northridge alone, Johnson said.

Doctors in Ventura and Northridge said they had never seen a case in a child so young, although federal statistics indicate that several infants have fallen prey to the unusual infection.

Doctors remain mystified about how Rosa developed the deadly condition, but believe it sprang from a simple staph infection--staphylococcus aureus, the same bacteria that cause boils and other relatively harmless skin conditions.

Baby Rosa’s parents, who live in Oxnard, told hospital officials they did not wish to be identified. They did not attend a press conference at the hospital Tuesday.

Her parents first noticed something wrong June 30, when Rosa came down with a mild fever. Rosa’s mother took the baby to a doctor in Oxnard, who took a throat culture and sent the girl home, said Dr. Hooshang Semnani, head of pediatric critical care at Northridge Hospital. Semnani said he did not know the identity of the doctor.

On July 1, Rosa’s mother took her to see a family doctor in Tijuana. After spotting a bright red rash on Rosa’s back, the physician told the mother to immediately drive back to Los Angeles and check Rosa into a hospital, Semnani said.

Rosa arrived at Ventura County Medical Center on Thursday afternoon with a 104-degree temperature and a severe rash covering most of her back, Semnani said. She was in shock. Emergency room doctors diagnosed her problem as flesh-eating bacteria--necrotizing fasciitis, a potentially fatal condition.

Thursday night, surgeons removed part of the baby’s right side, back and chest to rid her body of the rapidly moving bacteria, Semnani said.

On Friday morning, Baby Rosa was transferred to Northridge Hospital where doctors stabilized her in the hyperbaric chamber and drained three previously undiscovered abscesses containing the bacteria.

“It is really the host, the baby in this case, who is not handling what should be an easy-to-handle infection,” said Dr. John Alexander, head of hyperbaric and pulmonary medicine for Northridge Hospital. “Why this occurs . . . we don’t know all the answers. When it does, these infections grow extremely rapidly.”

On Tuesday afternoon, a team of doctors began grafting 77.5 square inches of cadaver skin over Baby Rosa’s open wound, a temporary sheath to prevent infection until enough of the baby’s own skin can be harvested from healthy areas of her body, Bresnick said.

Treating the wound is similar to treating a burn victim, he said. Treating Baby Rosa will be especially difficult, however, because her body has little healthy skin to choose from.

If she survives, Baby Rosa will likely undergo a series of complicated and costly operations to repair the damage and still will be left with a significant deformity, Bresnick said.

“You can picture almost a shark bite deformity,” Bresnick said.

The flesh-eating disease can be caused by a number of virulent bacteria able to penetrate deep into the body. The bacteria cause blood vessels to collapse, choking off the flow of blood and killing the oxygen-starved tissue.

An estimated 500 to 1,500 cases of necrotizing fasciitis are diagnosed every year in the United States, and about one out of every five patients dies, according to the Centers for Disease Control and Prevention in Atlanta.

The infection first gained local attention in December 1994, when two people in Southern California died after contracting the condition. One of them was Thomas Lakin, chancellor of the Ventura County Community College District.

The hospital’s press conference was held the same day that health officials told the Los Angeles Board of Supervisors they have confirmed allegations that a doctor at Northridge Hospital demanded cash from a Medi-Cal patient before providing epidural anesthesia during childbirth. The county district attorney is reviewing the case for possible prosecution.

Northridge Hospital officials said they plan to seek reimbursement for the expenses Medi-Cal covers, but will proceed with Rosa’s treatment regardless.

They bristled at the suggestion they may be using the Baby Rosa case to deflect news reports about the investigation.

“This is not a publicity stunt,” Johnson said. “This is a tragedy. The family wanted to let people know about this condition.”