Editor’s note: This story includes images that some may find disturbing.
The small raised bump, maybe the size of a quarter, on his left thigh was a surprise to Donnie Adams when he first felt pain there.
The only explanation the Riverview man could come up with was that it happened when he intervened to stop a fracas at a family gathering two days earlier.
It looked like a bite, so on Feb. 14 he went to the emergency room at HCA Florida Northside Hospital in St. Petersburg for a tetanus shot and antibiotics.
Three days later and barely able to walk, Adams, 52, was back at the hospital. This time, he was rushed into emergency surgery, where general surgeon and wound care specialist Fritz Brink battled to save his leg — and possibly his life.
Every incision of Brink’s scalpel revealed bright red rotting flesh that stretched almost from knee to groin. About 70% of the tissue in the front of Adams’ thigh had to be cut out. A follow-up surgery was also needed to remove some remaining infected flesh.
And doctors have no doubt that this infection started from, of all things, a bite on his leg from one of his relatives.
Flesh-eating bacteria have posed a known danger to swimmers and others who enter the Gulf of Mexico with opens sores or cuts. Known as necrotizing fasciitis, the rapidly spreading bacteria kills tissue that surrounds muscles and nerves. But doctors at HCA Florida Northside Hospital say they have never seen a case like Adams’, where the infection was the result of a bite — from another human being.
Still, the diagnosis makes sense, Brink said. Warm and moist, human mouths are a perfect breeding ground for a multifarious array of bacteria that are normally destroyed by stomach acid.
The puncture of Adams’ skin, however, made it possible for bacteria to get into the layer of tissue beneath. Whether it was germs from the mouth of his relative or airborne microbes that penetrated the wound later may never be known.
“A human bite is dirtier than a dog bite as far as the kinds of bacteria that grows,” said Brink. “Normal bacteria in an abnormal spot can be a real problem.”
Brink had warned Adams before he was anesthetized for surgery that he might emerge with a decent-size wound. A gray dishwater ooze seeped out of his first incision, a telltale sign of necrotizing fasciitis. But Brink was not expecting to encounter so much infected flesh.
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Every inch of thigh he examined came with a tough choice.
“You’re torn between being as aggressive as you can be to stop the infection from spreading and leaving as much tissue behind so that it won’t take two years to heal,” Brink said.
Had Adams waited another day to return to hospital, the infection would likely have already spread to his abdomen and he would have needed to be placed in intensive care because of a high risk of sepsis shock, Brink said.
“It would have been tough to get control of the infection,” he said.
Adams spent almost three weeks recovering in the hospital. Even after he was discharged, he still faced up to six months of treatment to heal the wound that Adams joked made his leg look like it was “separated by two sharks.” His treatment regimen included visits to the Wound Care and Hyperbaric Medicine Center at HCA Florida Pasadena Hospital, where Brink used a therapy known as wound VAC.
A sponge is inserted in place of the missing tissue and is then covered with a plastic drape. Negative pressure or suction is then applied to the wound, stimulating the creation of new blood vessels and speeding up the healing process.
The wound dressing was changed three times a week sometimes, as needed. Brink continued to tend to Adams even when the patient’s insurance stopped covering treatment. Eventually, Adams learned how to use the wound VAC and change his own dressing.
Brink said his patient’s positivity and willingness to follow a recommended diet played a part in his wound healing in half the expected time.
Adams, who works at a funeral home, said he didn’t feel a bite at the time he stepped between two feuding family members. He dealt with the ordeal by praying and meditating, he said.
“The parties involved are very sorrowful,” he said.
His leg now sports a network of scars but is fully functional except for occasional pain, he said. He sees beauty in the blemishes.
“I’m grateful to have my leg and for the care I received,” he said.
Adams said he hopes his story will encourage others to be cautious and get wounds checked by medical professionals.
“You don’t know what is going on underneath,” he said. “It could be something that is life-threatening.”