A 34-year-old woman in New Orleans recently lost her arm and one of her breasts to necrotizing fasciitis — sometimes known as "flesh-eating disease" — after injecting herself with the dangerous new drug known as "bath salts." Her case is documented in the journal Orthopedics.
Bath salts get their name from their visual similarity to the soothing chemicals you put in your bath. But when used as a narcotic, they are anything but soothing. The drugs contain man-made substances known as methylmethcathinone (mephedrone) and methylenedioxypyrovalerone (MDPV). They have been likened to synthetic marijuana and produce a cocaine-like high. Now illegal in many states, bath salts can be snorted, injected or smoked. They cost as little as $25 for a 50-milligram packet.
According to the U.S. National Library of Medicine, necrotizing fasciitis (or necrotizing soft-tissue infection) is a rare bacterial infection that results in the death of muscles, skin and underlying tissue. One of the causes of this terrifying infection is Streptococcus pyogenes, often referred to as the "flesh-eating bacteria."
In the New Orleans woman's case, she came to an emergency room in Baton Rouge complaining of pain two days after injecting bath salts at a party. Doctors observed "extensive cellulitis extending to the mid portion of her upper arm," which was treated with antibiotics. But two days later, with the patient still in pain, a closer examination found that the tissue around the site where she had injected the bath salts was dead, and the infection was rapidly spreading.
With the woman's life at stake, doctors were forced to amputate her entire arm. They also performed a radical mastectomy and removed a portion of her chest wall. The level of surgery was necessary to provide what is known as "healthy tissue margins," meaning that the remaining tissue was unlikely to still contain the flesh-eating bacteria.
The patient survived and is healthy after extensive skin grafts and rehabilitation.
The paper's lead author, Dr. Russell Russo of the Louisiana State University Health Sciences Center, warned that necrotizing fasciitis is an "orthopedic emergency" but hard to diagnose since it "usually manifests as a less severe cellulitis or abscess while the majority of the damages rage beneath the surface of the skin." Quick and accurate diagnosis is essential to saving a patient's life, according to the paper, and the authors caution all emergency room doctors treating cases of bath salt intoxication to be cautious and look for potential Streptococcus infections.
According to MSNBC, the American Association of Poison Control Centers received more than 6,000 calls about bath salts in 2011, up from just 300 cases in 2010.
Bath salts can cause many other life-threatening medical emergencies. "Bath salts causes extreme heart rates and blood pressure fluctuations and temperatures," as well as extreme paranoia and hallucinations, according to Dr. Sam Saylor, an emergency room physician at Geisinger Wyoming Valley Medical Center in Pennsylvania, speaking to The Times Leader. Pennsylvania recently banned bath salts, but cases are still being reported.
A federal bill to ban bath salts was approved by the House of Representatives in December. Similar legislation has been introduced in the Senate, but Sen. Charles Grassley (R-Iowa) told American Medical News that the bill has been held up by Sen. Rand Paul (R- Ky.), who would not comment on the legislative hold.