Flesh eating bacteria

Man fights to stop flesh-eating bacteria

19 surgeries later, doctors expect him to recover

By SHIRLEY DANG of the Journal Sentinel staff

Saturday, August 3, 2002

What started as a pain in the armpit eventually ate away half his torso.

Today, Scott Prodzinski lies on a gurney at St. Luke's Medical Center. His ballplayer's bulk puffs up under the hospital-blue sheet, then caves in several inches where the infection and subsequent surgeries hollowed out his chest and left side.

Prodzinski is recovering from an 18-hour surgery, his 19th operation in two months. Earlier this week, doctors took stomach tissue to cover his chest, partially consumed by flesh-eating bacteria.

"It looks like he was attacked by a bear," said Scott's mother, Mary Prodzinski. "His sternum and chest area is just eaten away."

Prodzinski, 31, felt sore underneath his left arm on a Tuesday in late May. The Milwaukee man visited a doctor, who said Prodzinski probably pulled a muscle while working in delivery at a parts equipment company.

But the pain spread quickly across his chest and down his back. By Thursday night, he had a fever and trouble breathing, said his wife, Diane Prodzinski.

That Friday, in the St. Luke's emergency room, doctors pumped two liters of puss and blood from his chest while the bacteria, group A streptococcus, ate their way across his trunk.

His kidneys were failing, and he was put on dialysis for five days while doctors removed dead tissue from his left arm and across his chest.

Since then, the father of two contracted a secondary infection and suffered a minor stroke.

"Everything that could have gone wrong has gone wrong," said Mary Prodzinski.

Last year, the state received five reports of necrotizing fasciitis, the condition caused by flesh-eating bacteria, said Susann Ahrabi-Fard, an epidemiologist at the Wisconsin Division of Public Health.

More cases probably occurred, since doctors are not required to report the disease unless it enters the bloodstream, she added.

Usually, flesh-eating bacteria seriously affect the elderly, young children and those with weak immune systems, said Ahrabi-Fard. Risk factors also include chronic diseases, heart disease and intravenous drug use, she said.

Doctors do not know exactly how Prodzinski, a healthy man who played softball five times a week, contracted the infection.

"I don't think anyone can tell you what the cause was," said Jeffrey Niezgoda, therapy and medical director of St. Luke's Center for Comprehensive Wound Care and Hyperbaric Oxygen Therapy.

Physician Krishna Neni said Scott Prodzinski had probably been exposed to the bacteria when his children had sore throats. The bacteria might have entered the bloodstream when he tore a chest muscle and bled internally, Neni said.

There is only a one-in-a-million chance of contracting and dying from necrotizing fasciitis, according to the Centers for Disease Control and Prevention. Cases usually involve extremities such as hands and legs and can be controlled with antibiotics and minor surgery.

The mortality rate is 20% to 30%, according to the CDC.

But the mortality rate exceeds 75% for rare cases of necrotizing fasciitis of the trunk and neck, which Prodzinski developed, his doctors said.

"What you don't want to do is miss an area that shows signs of early infection," Niezgoda said. "In this type of infection, the onset and the progression is extremely rapid. People can die within 24 hours if they don't get aggressive therapy."

In the first four days, doctors operated daily, sometimes twice a day, to keep the infection from spreading. Doctors repeatedly cut out Prodzinski's remaining flesh that might have harbored the invasive bacteria, which also can cause strep throat, scarlet fever and toxic shock.

"Every 12 hours, we went back into the operating room to make sure we were ahead of the game," Neni said. "Obviously, we couldn't tell in the first three days which direction it would go."

Prodzinski also underwent three rounds daily in a hyperbaric oxygen chamber. The machine blasts cells with pure, high-pressure oxygen, forcing it into cells that are cut off from the blood supply, which usually carries oxygen to tissues.

Eventually, stress on Prodzinski's body from repeated surgery and intravenous antibiotics and pain medication taxed his liver into dysfunction, Neni said.

In early July, Prodzinski contracted a secondary infection of the bacteria pseudomonas. Then, on the Fourth of July, Prodzinski suffered a minor stroke, from which he has fully recovered, Neni said.

Each night, Diane Prodzinski visits her husband at the hospital, sometimes bringing their two children, Amanda, 3, and Joey, 1.

"He's starting to talk, and Scotty's not there," said Mary Prodzinski. "It's like Rip Van Winkle: 'What'd I miss?' That's the hard part."

To keep Prodzinski company, his wife plays tapes of Amanda singing songs such as "Edelweiss" and "Over the Rainbow."

In his room, where he watches "Seinfeld" and pro wrestling, Diane tapes Amanda's crayon drawings of her hand to the wall, and bobble- headed baseball figures sit, still in their boxes.

Friends, family and hospital staff support the Prodzinskis as best they can.

For surviving so much, Prodzinski seems in good spirits.

He will need four to six weeks to recover, Neni said, though he ate on his own and took his first 10 or 20 steps a week ago.

"We have a lot of people praying for us," said Diane Prodzinski.

"Till he comes home," said Mary Prodzinski.

HOW TO HELP

To raise money for hospital bills, friends of Scott Prodzinski are hosting a baseball benefit game, auction and kids fair at 1 p.m. Sunday at KP Classics, Highway 164 and National Ave., Big Bend.

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