Aimee Copeland, a 24-year old master's student at the University of West Georgia, has necrotizing fasciitis caused by Aeromonas hydrophila, a bacteria usually linked to intestinal disease.
"This bacteria is a common cause of diarrheal illness," said Dr. William Schaffner, chair of preventive medicine at Vanderbilt University Medical Center in Nashville, Tenn., and president of the National Foundation for Infectious Diseases. "For it to cause a deep wound infection that dissolves tissue, that's not common."
Copeland was riding a homemade zip line near the Little Tallapoosa River May 1 when the line snapped, slashing open her left calf. Doctors at Tanner Medical Center in Carrollton, Ga., cleaned the gash and closed it with 22 staples, but Copeland returned to the hospital the next day complaining of severe pain.
"The symptom that should ring alarm bells is serious, unremitting pain," said Schaffner, describing how the bacteria can, under rare circumstances, burrow deep into a wound and dissolve muscle and other tissue.
Doctors sent Copeland home with a prescription for painkillers, according to her Father, Andy, but the pain persisted. Copeland returned to the hospital the following day and was released again, this time with antibiotics. On Friday, three full days after the zip line accident, Copeland was diagnosed with necrotizing fasciitis and her left leg was amputated at the hip.
"It's a miracle she made it past Friday night," Andy Copeland told ABC affiliate WSBTV.
The two main treatments for necrotizing fasciitis disease are antibiotics and surgery to remove the infected tissue, Schaffner said, stressing that bacteria left behind can cause a deadly blood infection.
"You have to look at the wound and think, 'This is as far as the infection has gone; now I have to cut even further,'" he said.
After her leg was amputated, Copeland was flown to Joseph M. Still Burn Center in Augusta, Ga., where doctors removed parts of her abdomen. She is in critical condition.
Copeland's prognosis is unknown, but mortality rates for Aeromonas-related necrotizing fasciitis are upward of 60 percent, according to a 2010 report published in the journal Clinical Microbiology Reviews.
"It's a very serious infection, but most people who get it have underlying conditions compromise their immune systems," said Schaffner. "This woman is young and, as far as we know, otherwise healthy. Let's hope it doesn't carry that kind of grave prognosis."
Tuesday, one week after the accident, Copeland's temperature spiked and she lost her pulse.
"They actually were able to do CPR and resuscitate her very quickly," Andy Copeland told WSBTV. "I don't want people with long faces right now because we already had a miracle Friday night when she survived. … I just believe we have to stay positive right now to honor Aimee."
Up to 70 percent of Aeromonas wound infections stem from recreational sporting activities, such as swimming or fishing, or occupational injuries, according to the 2010 report. But Schaffner said the tragedy should not keep people out of the water.
"Obviously take good care and attend to any injuries. But people should continue swimming, boating and fishing in our many lakes, rivers and streams," he said. "Unfortunately, there are times when we're going to have a bad result despite everything we do to prevent it."
To reduce the risk of necrotizing fasciitis, all wounds big and small should be immediately cleaned, treated with antimicrobial ointment and covered with sterile bandages, according to the National Necrotizing Fasciitis Foundation.
- Disease & Medical Conditions
- necrotizing fasciitis