Mildenhall woman survives flesh-eating bacteria — twice
Stars and Stripes October 16, 2005
RAF MILDENHALL, England — Bacteria slipped inside Ana Kinner’s body in January and began devouring the flesh from her bones.
Three times, surgeons chopped away large chunks of her left thigh in attempts to expel the bacterial invader, saving her life as they cut.
But before the third surgery, nurses suggested she and her husband, Staff Sgt. Jarrod Kinner, say their farewells.
“You’ve been a good husband,” Ana told him, tears dripping down their cheeks, before nurses wheeled her to the operating room.
“I thought I was going to die,” she said.
A pulled muscleAna Kinner, 31, reached down to pick up a tissue from the floor of the family’s on-base housing unit at RAF Mildenhall on Jan. 17, a Monday, and felt a twinge in her left thigh.
“I thought I had bent over wrong and pulled a muscle,” she said. “I took some Tylenol and went to bed.”
Soon, she developed flulike symptoms and couldn’t even get out of bed to help her children, Analisa, 10, and Zachery, 7, get ready for school. Jarrod Kinner, 33, of the 100th Security Forces Squadron, was concerned enough to ask his commander for time to go home and help out.
“I said, ‘Look, my wife is never like this,’ ” he recalled.
The painful area turned black, making them think it was merely a bruise.
But on Friday, Ana nearly passed out while getting out of the shower. That day, she went to the family practice clinic at RAF Lakenheath.
“From there, it was a whirlwind,” Jarrod said.
Doctors and nurses swirled about, doing everything to determine the cause of Ana’s misery.
Her heart rate was low. Her blood pressure was high. Her temperature had reached 104 degrees. Antibiotics had no effect.
One of the physicians on duty was Dr. (Lt. Col.) Jeffrey Marchessault, an orthopedic surgeon.
“Very few things act the way her presentation did,” Marchessault said. “This was a very benign looking thing at one point and it just continued to get worse.”
He feared Ana had necrotizing fasciitis.
“I’ve seen it less than five times,” he said. “It is rare, but once you’ve seen it, it makes an indelible impression on you. It’s an extremely virulent infection. It will spread like wildfire.”
1 in 200,000Necrotizing fasciitis is caused by Group A streptococcus, according to Ros O’Loughlin, epidemic intelligence service officer for the Centers for Disease Control and Prevention in Atlanta. Many people carry the bacteria on their skin at all times without problems.
“Normally, it can cause strep throat, which is not serious,” she said in a telephone interview.
But on rare occasions, it can invade the body, lodging in places where bacteria should not be found, such as blood, muscle or the lungs, she said. A cut or bruise or open sore can provide the portal for the bacteria.
This may result in a variety of illnesses, such as streptococcal toxic shock syndrome. But the most rare is necrotizing fasciitis, O’Loughlin said, sometimes referred to as “flesh-eating bacteria.”
“It kills the tissue,” she said. “The treatment is to cut away the dead tissue.”
Little is understood about necrotizing fasciitis, partly because it is so rare. O’Loughlin said the CDC numbers show about one person in 200,000 get the disease annually. About 20 percent of them die.
Most at risk are old people and people with chronic illnesses, although, O’Loughlin said, it can strike young, healthy people, as well.
‘We’re losing her’Marchessault had seen necrotizing fasciitis in patients during his residency at Texas Tech University in Lubbock, taking part in surgeries that cut away all of the skin, muscle and tissue necessary to rid the body of the bacteria.
He could have performed Ana’s surgery at RAF Lakenheath, he said, but the staff was hit by deployments and post-operative support was short-handed.
On Saturday morning — five days after first falling ill — Ana was rushed to Addenbrooke’s Hospital in Cambridge, about 30 miles south. Marchessault rode along and explained the situation to British doctors.
Jarrod arrived as his wife was being taken to surgery.
“She stopped breathing. She went into a comalike state,” he said. “One nurse is saying, ‘We’re losing her.’ ”
Doctors performed two surgeries in the next 24 hours. They removed a chunk of her left thigh about 3 inches deep and the size of a hamburger in the first surgery.
But a doctor examined her and said the bacteria was still gnawing away. In a second surgery the next day, Jarrod said, doctors removed “about two-thirds of her thigh.”
Jarrod had spent time in prayer at the hospital chapel. Now, with his wife out of surgery, he had two children to manage. He planned a commissary trip.
“I remembered, I don’t know what my kids eat,” he said. “I don’t know what my wife does. I just started crying.”
Their daughter, Analisa, was struggling, too. The news that her mother was in the hospital scared her. She tried to be strong, she said, but “it was hard.”
With the bacteria gone, doctors began repairing the damage. They performed a surgery in which they used a muscle in Ana’s lower abdomen to build a new thigh.
Ana called it a “tummy tuck” and joked, “I got a little bonus out of it.”
Also, she said, she now has a belly button on her thigh.
She was released from Addenbrooke’s and sent home to recover from her ordeal on Feb. 14, a Valentine’s Day surprise for her children.
Necrotizing fasciitis … againTwo weeks later, Anna developed a fever. Her thigh — her original thigh, near the skin grafts — had turned red. A doctor at Lakenheath told her it looked like the bacteria had returned.
She was given antibiotics and rushed to Addenbrooke’s, where she was prepared for immediate surgery.
“[A nurse] told me I had to say my goodbyes to her and get everything in order because she didn’t think Ana was going to make it out of surgery,” Jarrod said.
“The nurses wheeling me into surgery were crying,” Ana added.
Doctors removed a wedge of her thigh about 2 inches deep and 6 inches long. She awoke with a tube in her mouth, but she was alive and doctors assured her they had removed the bacteria completely.
The Kinners said doctors are unsure whether Ana had a new bout of necrotizing fasciitis or the earlier surgeries simply had not removed it all. O’Loughlin guessed that it was a continuation of the earlier attack because recurrence is not a characteristic of the disease.
There has been more plastic surgery, and there are more surgeries in Ana’s future, just to put the finishing touches on her thigh.
But it looks like the nightmare is behind the Kinner family.
Ana is again a leader for her daughter’s Girl Scout troop. She is an active volunteer, mother and wife, once again getting the kids ready for school each morning.
The educated guess is that the bacteria entered Ana’s body through a particularly bad eczema sore on her left foot.
She has written of her ordeal on a Web site for survivors of necrotizing fasciitis, www.nnff.org.
That’s important, she said.
“I’m on the survivor network.”