5 Awful Truths About Surviving Flesh-Eating Bacteria

You've probably heard about flesh-eating bacteria. Every year or so brings some new story of people swimming in the wrong lake or by the wrong Floridian beach and winding up with a fat case of flesh rot. Are these bacteria as nightmarish as they sound? And if so, how the hell does anyone survive them?

We sat down with a woman whose father contracted Fournier's Gangrene, an aggressive brand of flesh-eating bacteria famed for attacking its victims crotch-first. In the months that followed, she got a crash course in one of the most frightening sicknesses on earth ... and also learned way, way too much about her own father's testicular health.

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5
Flesh-Eating Bacteria Is Always Here, Waiting

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Behold, Streptococcus pyogenes:

CDC
Bacteria so vile it's available in swastika shape.

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It looks like the version of Snake that God would play while waiting for His dentist appointment, but it's one of the deadliest bacteria in the world. Strepto-P is a flesh-eating bacterium, one of the most common causes of necrotizing fasciitis. That's a polite way of saying that it makes you rot to death.

Streptococcus entered my life unexpectedly, shortly after I returned from an overseas trip. My family was throwing a birthday brunch, which I begged off in the name of jet lag. My mom assured me that was fine, because Dad was fighting some sort of stomach bug, and next weekend would be better, anyway.

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Three days later, he was in a coma.

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You don't know rescheduling guilt until "now they're in a coma" rescheduling guilt.

That "stomach bug" wasn't a stomach bug at all. My dad had been dealing with pain in his groin, and he'd lied about it because he was embarrassed. By the time it got bad enough that my mom forced him to show her what was wrong, his penis had retracted entirely into his body, and his testicles had swollen to the size of a grapefruit and turned black. The parts that weren't black were an angry, swollen red.

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Even at the hospital, the doctors didn't know what was wrong. He went in late that evening and almost immediately had a team of doctors around him. Waiting for five hours at the ER isn't fun, but it turns out that getting treated immediately is a really bad sign. His heart started beating wildly, his kidneys started f*****g up, and before long he was on oxygen -- then a ventilator. By the time they resorted to having a machine do the lunging for him, we knew he was dying. We didn't know why, though, and for a while, it didn't look like he'd live. The hospital assigned a nurse to my mom to keep her calm.

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This proved impossible, even with the ER's medicinal kittens.

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Untreated, necrotizing fasciitis has a 100 percent mortality rate. With modern medicine on their side, "only" 30-40 percent of sufferers die. My dad's case happened because his (undiagnosed) diabetes lowered his immune system's defenses enough to let the streptococcus in. About half of the people who come down with Fournier's Gangrene (the fancy term for "literal crotch rot") have diabetes.

But even if you're the spitting image of health, Mr. Strepto is just waiting to make a ruin out of your coccus. Between 15-30 percent of the population carry flesh-eating bacteria around in their daily lives without suffering any symptoms. Then their immune system gets compromised, or they wind up with an open wound, and BAM. One terrifying case you can read about involved a healthy 29-year-old who made the fool choice to masturbate with soap instead of lube. Go ahead, click that link. I dare you.

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4
It's Usually Misdiagnosed

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One reason necrotizing fasciitis kills so many people is that it's rare, and thus difficult to diagnose. Doctors don't jump to assume "flesh-eating bacteria" when you complain about sore balls (or sore whatevers), so the vast majority of cases are misdiagnosed. The "flesh-eating" part makes it sound spectacular, but it's not really a visible infection. It's essentially inside-out zombification.

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Not to be confused with the upcoming Pixar sequel.

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Most of the symptoms are things that could have a bunch of different causes; "pain" and "swelling," etc. If you're lucky, you get blisters full of black pus that smell like rotting flesh when they pop. That's your body trying to "debride" -- rid itself -- of decomposing flesh. Yes, this is a disease for which black rotting pus is a "best case" scenario.

Doctors have a lot on their plate, so it's not hard to see why they might misdiagnose something like this. Unfortunately, a missed diagnosis bumps the fatality rate from 20 percent up to 80 percent. Delaying treatment by even a few hours can be fatal. Gangrene can spread up to a centimeter an hour, which is like NASCAR speed for bacteria.

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Consult your doctor before any "home remedies".

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We left the hospital on the first evening at around 10 p.m. The doctors were cautiously optimistic that they'd be able to figure out what was wrong with my dad. Then they called again at around 1 a.m. to say that they were rushing him into surgery. They weren't willing to give us his odds of survival; all they told us was, "Pray." Whether you're religious or not, that's a terrible thing to hear from a surgeon.

Dad survived the initial surgery, but it was close. It lasted several hours, and they actually had to bring in a "relief" surgeon at one point. They finally managed to diagnose him, and ... that's the only good news we got from the first surgery. You know things are bad when hearing that your dad is definitely "rotting from the inside out" is a step up from where things were.

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3
The Treatment Can Drive You Insane

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The infection's effects are right there in the name "necrotising fasciitis." "Necro" means decay, and fascia is connective tissue in the body that holds our bodies together and supports all of our meaty bits. An "-itis" is an inflammation. All of this leads to lots of swelling, pain, and dead tissue just sitting there. Inside you. With no way out.

James Heilman
The tissue can't even escape its horror through suicide. It's already dead.

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Untreated, your body deals with all this extra, rotting You via debridement. If you're lucky enough to be in a hospital, like my dad, they simply cut all the dead skin off and scoop out the infection, and they don't close you up after. Instead, they use a weird stiff bandage with a vacuum seal to keep the wound from getting even more infected. They vacuum sealed my dad shut for almost three months, regularly opening him back up to remove more infection. My dad was lucky enough to merely lose a few pounds of skin; some people lose entire limbs.

Now, I've watched my fair share of TV and movies, and I had a Hollywood-programmed idea in my head of how an Intensive Care Unit ought to look. Those shows get it wrong, generally because they're portraying the hospital as someone's workplace, more a backdrop for the cast's wacky adventures and romantic liaisons than a place where very sick people fight to stay alive. Real ICUs are a little nightmarish.

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There wasn't even a British guy to assure us it wasn't lupus.

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For instance, the lights are on all the time. I assume the doctors are fine with that, but it's awful for patients -- life is one long halogen-lit day. Fortunately, most of those patients are unconscious. But not all of them, and those unlucky conscious few also have to deal with the noise. ICUs are filled with shrill alarms. Everyone in there is hooked up to about a hundred different monitors. The second any of them encounters the tiniest problem or deviation from the norm, they start freaking out.

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I didn't realize what a problem this could be until my dad woke up. First off, the word "awake" doesn't mean what it normally does to patients in the ICU. My dad was on, conservatively, all of the drugs. At one point, my brother and I tried to count the holes they'd put in him, and we topped out at around 30. Since they can only poke so many needles, catheters, arterial lines, shunts, stints, etc into you at a time, what they do is make little trees with the IVs so they can feed the patients all the dozens of drugs that they need.

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"Look, it's either this or the megasuppository."

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Those drugs, combined with the light, noise, activity, and shock of waking up for the first time in days can lead to a lovely condition called ICU psychosis. My dad was so stunned and bewildered that he reacted to consciousness by immediately trying to eat a nurse. She was feeding him his pills, but he didn't understand what was happening, saw something near his mouth, and bit as hard as he could.

We started feeding him with a spoon to ward off the biting ... but only after he'd bitten three nurses and an anesthesiologist. He broke a couple of those plastic spoons, too. The psychosis flared in and out for days. There were even some hallucinations (I think) of family trips we'd taken in the past. The ICU is a hell of a drug, is what I'm saying.

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2
Your Goalpost For "Horrifying" Changes

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Trauma changes the way you process new information. That first horrible phone call that my dad was going to the ER stopped my whole world. I didn't even notice I was crying until one of my co-workers walked up with a box of tissues. My eyes knew what I was supposed to feel, even before my brain caught up to reality.

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The realization finally hit sometime between seeing my dad in the ICU for the first time and hearing the doctor say, in essence, "We've got no flipping clue what's wrong with him. Maybe it's ... ghosts?"

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"And I would have gotten away with it too, if it wasn't for your meddling vancomycin!"

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I didn't sleep for a couple of days after that. It was like I'd run into a brick wall made of adrenaline. For days, I wouldn't eat unless someone stuck the food in my hand. I drank tea constantly, though, because I'm Australian and that's what we do when we're stressed the hell out. After those first three days, when the mortal danger was gone, it stopped mattering to me that he was in the ICU. Yeah, I was surprised to learn that my dad had contracted a flesh-eating bacteria. But since they didn't think he was going to die anymore, my general reaction was "meh." That became my reaction to every not-immediately-life-threatening problem that cropped up during his recovery.

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His kidneys still aren't working? Lazy bastards. The nurse misheard his blood sugar level and nearly killed him with too much insulin? That's fine! What, the nurse gave him sugar next to counteract the insulin and nearly killed him again? That's still fine! As long as the word "nearly" is in there, I'm fine with it. The poor nurse was more traumatized than his family. I guess this was her first time nearly killing someone.

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Luckily, spare med kits are available for staff use.

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The trauma of having a doctor tell me my dad probably wouldn't survive surgery had cancelled out my ability to care about anything less urgent than that. My maid of honor was in a car accident and broke her back a couple of months before my wedding. But because she wasn't in the ICU, I didn't label it as "serious" in my head. What, I had to find a way to fit her dress over the back brace? Compared to my dad's emergency groin surgery, that barely qualified as a speed bump.

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1
Recovery Is A Long Journey

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A plastic surgeon had to reconstruct a lot of my father's body afterwards. Not only had he lost pounds of skin, but he lost pounds of fat during his coma. There wasn't enough flesh on his body to close up his wounds. His testicles were skinless and red, so the surgeon went in, took excess skin from his now-thinner thighs and used that to reconstruct his testes and penis and abdominal flesh.

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"Here's a couple extra inches. On us, bud."

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He had a colostomy bag installed during this process, because the whole "lack of skin" thing made traditional pooping a dangerous proposition. That bag stayed in for a year and a half. Colostomy bag removal time should've been a cause for grand celebration. What could be more festive than "dad can poop without a bag again!" day?

But he wound up having a bad reaction to the anesthetics -- he didn't wake up when he should've after the removal surgery. Normally this wouldn't be a big deal, but because he was still colonized with the streptococcus, he couldn't go into the general patient population to recover. It would've spread from his body to the other patients. So he had to go to the ICU again to recuperate. We joked that he'd done it on purpose, because the isolation ward was the only part of the ICU he hadn't seen yet.

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He only needed an out-of-body experience to win ICU bingo.

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They released him from the hospital a day later, but he wasn't clear of the anesthetic. In fact, six months later, he still wasn't fully sober. Some patients are particularly sensitive to anesthetic. The "bewilderment" can range from a mild brain fog the next day (basically a surgery hangover) to months and months of confusion, short-term memory loss, and a s****y attention span. In my dad's case, all that lasted more than a year.

But hey, he's alive. And considering he spent three months battling a flesh-rotting zombie disease, that's pretty incredible.

Robert Evans is the head of Cracked's personal experience article section, and he has a Twitter.

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