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Woman loses arm to flesh-eating bacteria from bath salts

A New Orleans woman’s experiment with the illicit drugs dubbed “bath salts” cost her her arm -- and nearly her life -- after she was ravaged by flesh-eating bacteria that invaded an injection site. 

The 34-year-old woman showed up at a Louisiana hospital complaining of pain and redness on her right forearm, where there was a puncture wound the woman admitted was a needle stick. She said the symptoms started two days after she injected bath salts at party, according to a case report published online in the journal Orthopedics.

Doctors gave her strong antibiotics for a skin infection and she seemed to get better. Two days later, however, the patient was still in pain. On closer examination, doctors discovered growing redness, sloughing skin and a smelly drainage, the report said.

Suspecting a growing infection, doctors immediately sent the woman into surgery. They quickly discovered dead muscle surrounding the injection site in her forearm, and an infection moving so fast doctors could see it killing healthy tissue in its path, the report said.

Fearing for the woman's life, doctors removed her right arm and shoulder and stripped away the dead muscle. They also performed a radical mastectomy and cut away more unhealthy skin. 

The final diagnosis was necrotizing fasciitis caused by streptococcus bacteria. Such flesh-eating infections can kill quickly, with victims requiring surgery within an average of 25 hours of admission in order to survive, according to one study.

Dr. Russell Russo,  a third-year orthopedic resident at the Louisiana State University Health Sciences Center, was the lead author on the paper. He and the other authors worried that the growing popularity of illicit bath salts could spur a rise in the deadly infections.

The drugs, which are powerful synthetic stimulants, became popular in Western Europe in 2009 and showed up in the U.S. in Louisiana and Kentucky in August 2010. They’ve been smoked, snorted, taken orally and, now, injected. 

In 2010, the American Association of Poison Control centers received about 300 calls about bath salts. Last year, the number climbed to more than 6,000, records show.

At least 16 states have enacted emergency bans on bath salts and the federal Drug Enforcement Agency banned three chemicals used to make them last fall. But Russo and his colleagues are warning other emergency department health workers to be vigilant when patients show up with skin infections after injections

“The best treatment is prevention with public, street-based education and early detection,” Russo wrote.

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