The patient with the deadly bacteria is the first to survive.
A woman in Australia has become the third person to become infected with the bacterium that causes the deadly blackleg disease in cattle and sheep. According to a new case report, she is the only survivor.
After working in the garden without gloves, the 48-year-old woman suffered from nausea, vomiting and diarrhea for three days. She also developed pain in the right lower quadrant of her abdomen, which gradually worsened. She went to the hospital. Blood tests showed that her kidneys and liver had failed and lactic acid had accumulated in her bloodstream. This substance is produced by muscles during high-intensity exercise. It's also an indicator of septic shock.
Although a computed tomography (CT) scan of her abdomen showed no signs of inflammation or infection, doctors prescribed antibiotics as a precaution.
Five hours later, her abdominal pain became so severe that doctors performed another CT scan. This time it became apparent that her large and blind intestines were inflamed. She was admitted to the intensive care unit. Two days later, a blood test revealed that the woman had a deadly type of bacteria called Clostridium chauvoei.
These bacteria normally live in the soil in the form of spores that, when swallowed or inhaled, enter the bloodstream and then into muscle tissue. When oxygen levels in the muscle are reduced - for example, during exercise - the spores germinate and produce toxins. This includes those that destroy blood cells and enzymes that break down DNA.
In cattle, the host of C. chauvoei, it's the destruction of cells that leads to the characteristic appearance of blackleg. Before the infection, the patient was just working in the garden with her bare hands, which were covered with scratches from the house cat. This is probably how she became infected, the authors of the medical case report wrote.
Doctors prescribed her specific antibiotics to kill the bacteria, as well as hyperbaric oxygen therapy (HBO). In this procedure, the patient is placed in a high-pressure chamber containing only oxygen. This helps stop the bacteria from growing because they normally live in an environment without oxygen. This is how doctors wanted to reduce tissue death. Thanks to the treatment, her kidneys and liver started working again, and her lactic acid levels decreased so much that she was discharged from the hospital.
A few days later, however, the abdominal pain and diarrhea returned. A new CT scan showed that holes had appeared in her colon. Later, the patient was confirmed to have a die-off of intestinal tissue - necrotizing enterocolitis. As a result, surgeons removed her right side of her colon and installed a stoma, which redirects the colon into an opening in the abdomen so that feces can safely leave the body.
Two and a half weeks later, the woman's health returned to normal, and the stoma was removed three months later.
So far, doctors have only seen two patients infected with C. chauvoei, and both died as a result of the infection. One had a weakened immune system and the other had a serious soft tissue infection, anaerobic gangrene. It could not be cured.
The authors of the report suggested that the Australian woman survived because she was treated early with antibiotics, had emergency surgery, and had no other "serious" illnesses. HBO may have helped too, although doctors noted that they did not have enough evidence to support this assumption.
The case report is published in the Medical Journal of Australia.