Swallowed bone causes flesh-eating bacterial infection

By Lee Chung-hsien and Chen Wei-han  /  Staff reporter, with staff writer

Mon, Jan 26, 2015 - Page 3

An elderly man from Taichung has survived a potentially fatal flesh-eating disease caused by a 4cm long fish bone that had pierced his digestive tract before reappearing in his rectum.

A resident of the city’s Fengyuan District (豐原), the 73-year-old, surnamed Lee (李), is a diabetic, and is also paralyzed on one side of his body following a stroke.

Lee told a surgeon at the city’s hospital, Lai Chi-hung (賴基鴻), that he had eaten the fish bone by accident.

According to his family, Lee had recently been experiencing a lack of appetite and had a fever for a few days before visiting the hospital.

After being examined, which included a CT scan, Lee was diagnosed with necrotizing fasciitis — a flesh-eating disease — deep in his perineum. He was developing complications including septic shock and multiple organ involvement, doctors said.

Fasciotomy and debridement — standard surgical procedures in treating flesh-eating diseases — were performed immediately, and the surgeons removed a thick, 4cm long fish bone.

The fish bone, which would normally have stayed in the stomach, had somehow traveled all the way through the small and large intestines, taking a 10m excursion inside the patient before settling in his anus, Lai added.

When the flesh-eating disease reaches the perineum via infected intestines or the urinary tract, it has an overall fatality rate of almost 100 percent if the patient does not promptly undergo surgery, the hospital’s infectious disease specialist Wang Wei-yao (王唯堯) said.

He added that fish bones accidentally swallowed usually become lodged in the throat or somewhere along the upper digestive tract, but Lee’s case was very rare.

According to Lai, surgeons have removed a wide variety of objects from patients’ intestines, including a persimmon pastry, a sweet potato, corn dough and mushrooms.

Caregivers are especially recommended to steam cook food to make sure that it is easily digestible for patients, Lai said.