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Baby Rosa’s Battle

TIMES STAFF WRITERS

Forced to fight for her life just 11 months after being born, Oxnard’s Baby Rosa is making a courageous recovery from a full-blown case of the so-called flesh-eating bacteria.

One doctor says the Oxnard infant’s fight to stay alive is nothing short of a miracle.

“I’ve never seen a case of the flesh-eating bacteria in a baby this young,” said Stephen Bresnick, the plastic surgeon leading the baby’s surgical team at Northridge Hospital Medical Center. “I think it’s miraculous she’s survived.

“But this is a pretty strong kid,” Bresnick added. “She was fighting with me over the weekend, slapping my hands away.”

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Rosa Icela Olvera was healthy enough to be taken off a ventilator Tuesday, and the temporary cadaver skin grafts covering her tiny frame were 90% successful, said Dr. Hooshang Semnani, head of pediatric critical care at Northridge Hospital, where Rosa has been receiving treatment since July 3.

Semnani cautioned that Rosa is still a high-risk patient who remains in intensive care. But “it looks like she is past the critical stage now,” he said.

Rosa’s parents have remained at her side since she was hospitalized. Relatives reached at their Oxnard home Wednesday declined to comment on her condition.

Doctors attached nearly a square foot of cadaver skin over Rosa’s chest, side and back on July 7, covering an open wound left when surgeons removed strips of tissue ravaged by the bacteria.

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Cadaver skin is used temporarily to prevent deadly infection, and is quickly rejected by the body. It will eventually be replaced by permanent grafts of Rosa’s own skin during a second surgery next week, Semnani said.

Treating such a wound is similar to treatment for a burn victim. Rosa’s case is especially difficult, however, because the flesh-eating bacteria destroyed 20% of her skin.

The grafts to cover her wounds will be taken from Rosa’s scalp and buttocks, because the scarring caused by the procedure will be hidden by her hair and clothing when she grows older, doctors said.

Rosa remained on large doses of antibiotics Wednesday to ward off possible infection, always a serious risk when a patient has lost so much skin area, the body’s barrier to many potentially deadly bacteria. Semnani said he plans to keep Rosa in intensive care for possibly another week, depending on her condition after the second skin graft.

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Doctors believe all of the deadly bacteria has been purged from Rosa’s body, either when surgeons at Ventura County Medical Center removed the infected muscle, fatty tissue and skin or by the heavy doses of antibiotics, Semnani said. Rosa did suffer a small bacterial infection in her lung after the skin-graft surgery, but it was unrelated to the flesh-eating bacteria and was quickly treated with antibiotics, Semnani said.

Rosa first became ill June 29 and was seen by three doctors, including one in Tijuana, before the potentially deadly condition was diagnosed during a second visit to the Ventura County Medical Center. She was transferred to the Northridge hospital July 3.

Officials with the state Department of Health Services said last week that they were launching an investigation into the medical care given to Rosa by Ventura County Medical Center. But Richard Ashby, the hospital’s medical director, said Wednesday he had yet to be contacted for information.

Ashby defended the hospital’s treatment of Rosa, noting that the flesh-eating bacteria is extremely rare.

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“We’re extremely proud of the care that we gave,” Ashby said. “We feel the diagnosis was proper. She was very sick when she came back from Tijuana, but she did not exhibit those [symptoms] 60 hours earlier.”

Kwang Sik Kim, head of the infectious diseases division at Childrens Hospital of Los Angeles, said accurate information on the frequency of flesh-eating bacteria cases is hard to come by.

Whatever the case, one thing is for certain, Kim said: The sooner it is detected, the easier it is to treat. Unfortunately, he said, many people are not diagnosed with necrotizing fasciitis until it is too late.

“If the people have been diagnosed early, all the horrible things you hear about flesh-eating bacteria would never happen,” Kim said. “The condition is very treatable, with little side effects. But most conditions are not treated until very late.

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“A lot of times, people come in with reports of excruciating pain, but there are no outward symptoms,” he added. “That should be a sign to doctors that it could be a deep, serious infection of some kind.”

But Mary Ann Adams, the infection control coordinator at Anaheim Memorial Hospital, noted that many doctors spend their entire careers without ever seeing a case of flesh-eating bacteria.

The hospital experienced a gruesome case of the condition when patient Ana Maria Garcia Serrano survived a nearly fatal battle with it earlier this year, losing a finger and parts of her legs.

It was the first case Adams had seen in 17 years at the hospital.

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“The gal we had here truly should have died,” Adams said. “Despite all she went through, somehow she survived.

“The hard thing for many people in the community to understand is, this spreads very rapidly,” she added. “By the time many people get to the emergency room, it is too late.”


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