Human Biology U of M researcher examines newly emerging deadly disease

Discussion in 'Human Biology' started by mscbkc070904, Apr 1, 2005.

  1. mscbkc070904

    mscbkc070904 Premium Member

    Researchers at the University of Minnesota have identified a newly emerging illness, named staphylococcal purpura fulminans. The disease begins as a respiratory tract infection, which then is infected by Staphylococcus aureus.

    The infection then moves to the lungs, making superantigens (bacterial toxins that activate large numbers of T cells), often leading to death due to hypertension and shock. Purpura fulminans has been identified in five cases in the Minneapolis-St. Paul, Minn., metropolitan area during 2000-2004, as described in the April 1, 2005 issue of Clinical Infectious Diseases.

    This new disease has also been determined in seven additional cases nationwide. Of the 12 known cases, only two patients have survived.

    Purpura fulminans is an acute illness commonly associated with meningococcemia or invasive streptococcal disease, and it is typically characterized by the depletion of clotting factors in the blood and skin lesions. Purpura fulminans refers to widespread severe purpura with extensive tissue damage and sloughing of skin. Purpura are skin lesions that may be many centimeters in diameter caused by the leakage of blood into the skin.

    "It is important to alert medical professionals about the symptoms and treatments of this new deadly disease," said Patrick Schlievert, Ph.D., professor of microbiology at the University of Minnesota Medical School. "We are continuing to study and monitor cases of purpura fulminans to better understand the causes and best treatment options."

    On the basis of experience, the University of Minnesota experts have identified three recommended treatments for purpura fulminans. Patients who present symptoms of purpura should receive antibiotic therapy not only against Neisseria meningitidis and streptococci, but also against methicillin-resistant S. aureus (MRSA), with the consideration that the staphylococcal disease may be more common than the two prior illnesses. Patients should also be given early administration of activated protein C (i.e., drotrecogin) in an attempt to minimize purpuric skin injury and to slow the inflammatory cascade before irreparable tissue injury occurs. In addition, because toxic shock syndrome is mediated by superantigens, it is possible that intravenous immunoglobulin therapy may be indicated.

    Of the five patients observed in the Minneapolis-St. Paul area during the period of 2000-2004, four of the patients were previously healthy and four of the patients were women. Schlievert and colleagues hypothesize that the clinical features of purpura fulminans and toxic shock syndrome seen in these patients resulted from massive cytokine release induced by the S. aureus strains.

    Source : University of Minnesota
     
  2. Bleys

    Bleys Phoenix Takes Flight Staff Member

    :o

    I've been looking for additional information on this ever since you posted without much success - that is until today when I found a case of PF from over two years ago:

    Although slightly different circumstances than the Minnesota cases - the PF came after the initial staph infection and attacked her legs, arms and breasts. It is frightening to see how powerful and resistance bacterial infections are becoming and how less able we are to fight them effectively with antibiotics.

    FAQ sheet on PF

    Earlier case study

    B.
     
  3. Icewolf

    Icewolf Premium Member

    out of interest in the interests of quelling any panic, how is it spread and is it moving quickly through the population or is it one of these slow bugs that few people catch?
     
  4. Katherine

    Katherine New Member

    I am looking for some answers on MRSA. My dad has this form of staph and I am not happy with the answers the hospital is providing us about exposure. He has been in the hospital for 16 weeks and suffers from liver diease, sepsis, bacterial pneumonia and now has had his gallbladder removed. They hospital said the staph was contained in the gallbladder wound and we were not at risk for contamination.
     
  5. Bleys

    Bleys Phoenix Takes Flight Staff Member

    Welcome to the Board Katherine.

    First - a little about MRSA.

    If the mrsa infection was localized to your dad's gallbladder and they removed it intact there should be no problem with it spreading. My youngest had a similar infection although not mrsa when her appendix ruptured. Her surgeon told us that the peritoneal wall had encapsulated the appendix over the course of many years due to inflammation. When it ruptured this actually prevented the toxins from the appendix from spreading throughout her abdomen. However, he still put a drainage tube into her abdomen and pumped her full of antibiotics for a week to just in case.

    Hospitals cannot prevent patients from getting staph infections but they can lessen the risk through proper sterlization and cleaning techniques. All of the cases of mrsa I have seen were picked up in Hospital - they are simply a great host for the infection.

    I wish your dad the best. Both he, and you, have a tremendous fight ahead of you. But you are doing everything right by asking questions. No one will advocate for your loved ones but you. Any time a treatment or medication is being administered - ask them to explain it to you and why they are doing it. We caught several mistakes when my daughter was ill and it has made me a pitbull in that regard.

    For additional reading - cdc mrsa faq

    Good luck to you Katherine,
    Bleys
     
  6. Katherine

    Katherine New Member

    Thank You for your response Bleys. I am just curious how they know its contained to the surgery wound. The gallbladder was actually removed 3 weeks ago and it was oozing and would not heal. They took some of this fluid and it tested positive for MRSA. The gallbladder was gangrenous. During his hospital stay he has had to deal with pneumonia, sepsis, low white platelets, elevated PTT among other things. He was released for two days that mother had to take care of the wound and most certainly exposed to the fluid from the wound. He had to go back to the hospital and undergo another surgery to close up the surgical wound and stop the oozing of fluids.

    We have seen many errors during Dad's hospital stay. In ICU he fell from his bed and had to have surgery to repair the cuts in his face. He was given Ativan and it nearly drove him nuts. Then he was given Amaryl which dropped his blood sugar to 8.

    I have been by dad's beside throughout the 16 weeks. I have a low immune system due to autoimmune disease. I am concerned about the MRSA and the possible coagulation risk because I have clotting and bleeding disorders as well.

    They started vacamyacin two days ago and he was moved to isolation. They just started using precautions at this time. How would you know that the 16 weeks before this he wasn't already a infected with the MRSA??
     
  7. Bleys

    Bleys Phoenix Takes Flight Staff Member

    Post operative infections are not uncommon especially if your dad's gallbladder was gangrenous. The mrsa that he finds himself with now most likely is a recent development as a result of his long stay and complications.

    I can't express to you enough to ask the doctors about this if you are worried and seek a second opinion if you feel his care is not adequate.