Being healthy with a strong immune system helps. You can't be on any immunosuppressive drugs, either.

Does the cut have to be open? If its scabbed over are you fine?

How soon do symptoms start if exposed?

Asking for a friend.

Cibalo said:

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My uncle got flesh eating bacteria and was never near any water. He opened an amazon box and got a paper cut on his finger that afternoon. That evening he went to a christmas party, came home and when he woke up in the morning his hand was swollen and painful.

HE went to the clinic and they rushed him to the hospital. Performed 3 surgeries; 1 to open up the wound and get as much of the infection out, 2 to install a central line for meds, and 3 to start cutting way dead tissue.

They found that putting him in for long periods of time in a hyperbarric chamber such that his blood became super saturated with oxygen greatly stopped the spread of the infection.

He went from the doctor saying they might take the whole arm, to below the elbow, to taking his ring and 2/3 of of the middle finger.

He was in the hospital for 3 weeks and then had to have a skin graf and rehab on his hand.

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Vibrio vulnificus is not the only bacteria that causes necrotizing fasciitis (aka flesh eating diease). Multiple types of bacteria can cause it and you do not have to be exposed to water of any kind to contract many of these types of bacteria.




The following is an excerpt from the UpToDate online article on necrotizing fasciitis (See the bolded portion regarding Vibrio vulnificus):

"Necrotizing fasciitis may be divided into two microbiologic categories: polymicrobial (type I) and monomicrobial infection (type II) :
Polymicrobial (type I) necrotizing infection is caused by aerobic and anaerobic bacteria.

Typically, at least one anaerobic species (most commonly Bacteroides, Clostridium, or Peptostreptococcus) is isolated in combination with Enterobacteriaceae (eg, Escherichia coli, Enterobacter, Klebsiella, Proteus) and one or more facultative anaerobic streptococci (other than group A Streptococcus [GAS]). Obligate aerobes (such as Pseudomonas aeruginosa) are rarely components of such mixed infections. Uncommonly, fungi (predominately Candida species) are recovered in polymicrobial (type I) necrotizing infection.

Fournier gangrene is caused by facultative organisms (E. coli, Klebsiella, enterococci) along with anaerobes (Bacteroides, Fusobacterium, Clostridium, anaerobic or microaerophilic streptococci). (See 'Involved sites' below.)

Necrotizing infection of the head and neck is usually caused by mouth anaerobes (such as Fusobacteria, anaerobic streptococci, Bacteroides, and spirochetes). (See 'Involved sites' below.)

Other terms for polymicrobial (type I) infection include synergistic necrotizing cellulitis and progressive bacterial synergistic gangrene.

Monomicrobial (type II) necrotizing infection is usually caused by GAS or other beta-hemolytic streptococci. Infection may also occur as a result of Staphylococcus aureus. Infection with no clear portal of entry occurs in about half of cases; in such circumstances, the pathogenesis of infection likely consists of hematogenous translocation of GAS from the throat (asymptomatic or symptomatic pharyngitis) to a site of blunt trauma or muscle strain.

M protein is an important virulence determinant of GAS. Necrotizing infection caused by GAS strains with M types 1 and 3 is associated with streptococcal toxic shock syndrome in about 50 percent of cases. GAS strains of these and other serotypes can produce pyrogenic exotoxins, which induce cytokine production, likely contributing to shock, tissue destruction, and organ failure. (See "Group A streptococcus: Virulence factors and pathogenic mechanisms" and "Invasive group A streptococcal infection and toxic shock syndrome: Epidemiology, clinical manifestations, and diagnosis".)

Less frequent causes of monomicrobial (type II) necrotizing infection include Vibrio vulnificus and Aeromonas hydrophila. Infections due to these pathogens typically occur in the setting of traumatic injury associated with sea water or fresh water, respectively. Other risk factors for necrotizing infection due to V. vulnificus include cirrhosis and ingestion of contaminated oysters. (See "Vibrio vulnificus infections".)

The incidence of necrotizing fasciitis ranges from 0.3 to 15 cases per 100,000 population:
Polymicrobial (type I) necrotizing fasciitis (caused by aerobic and anaerobic bacteria) usually occurs in older adults and/or in individuals with underlying comorbidities. The most important predisposing factor is diabetes, especially with associated peripheral vascular disease. (See 'Risk factors' below.)

Monomicrobial (type II) necrotizing fasciitis (most commonly caused by GAS) may occur in any age group and in individuals with no underlying comorbidities. In the United States, there are an estimated 3.5 cases of invasive GAS infections per 100,000 persons; necrotizing infections make up approximately 6 percent of these cases.

Necrotizing myositis Necrotizing myositis is an infection of skeletal muscle typically caused by group A Streptococcus (and other beta-hemolytic streptococci). It may be preceded by skin abrasions, blunt trauma, or heavy exercise. Necrotizing myositis is rare. One report noted 21 cases documented between 1900 and 1985; another review of over 20,000 autopsies noted 4 cases.
Clostridial myonecrosis (gas gangrene) is discussed separately. (See "Clostridial myonecrosis".)
Necrotizing cellulitis Necrotizing cellulitis is typically caused by anaerobic pathogens and may be divided into two types: clostridial (usually caused by Clostridium perfringens; less frequently Clostridium septicum) and nonclostridial (caused by polymicrobial infection).
In both types, crepitus is observed in the skin, but there is sparing of the fascia and deep muscles. Pain, swelling, and systemic toxicity are not prominent features, and the relative mildness helps distinguish cellulitis from clostridial myonecrosis (gas gangrene). (See "Clostridial myonecrosis".)"

Source (It is from a pay site and you have to have a subscription to access):
https://www.uptodate.com/contents/necrotizing-soft-tissue-infections?search=necrotizing%20fasciitis%20causes§ionRank=1&usage_type=default&anchor=H650406663&source=machineLearning&selectedTitle=1~140&display_rank=1#H650406663

Wounds with scabs are only minimally more protected from infection, but are still technically open wounds and you can definitely contract the disease through a scabbed over wound.

Interesting factoid - we see this syndrome in dogs, most often cause is Strep. canis. Not associated with water or swimming.

When do symptoms start?

AgsMnn said:

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When do symptoms start?

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Within 24 hours

03ki11erAG said:

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AgsMnn said:

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When do symptoms start?

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Within 24 hours

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Usually, though it doesn't really look much different than your average cellulitis at first. The rate of spread through the skin and severity of concomitant symptoms (fever, body aches, nausea, decreased urination, fatigue, etc., and laboratory abnormalities) are what really separate necrotizing fasciitis from run-of-the-mill cellulitis.

A lot of cellulitis that evolves into necrotizing fasciitis gets sent home from the ER or doctor's office with antibiotics the first time they present and comes back in to the doctor when the symptoms did not respond to treatment. The second time the patient is much sicker and this second presentation is often when they are actually admitted.

Good deal.

Have an ingrown toenail and we were fishing on the boat and took a nasty fall. Needless to say, the water was red afterwards.
I believe my pain is from the toe and the fall. Happened Saturday. Nothing looks different on my toe, it just seems there is more discomfort in my foot than normal.

This topic worries me a lot. Unfortunately, I'm very susceptible to staph folliculitis.

Might be worthwhile to have a doctor look at it in person and examine you.

Agreed. Get it checked out.

Thoughts on taking an 18 month old to Galveston with a fresh burn on his hand? My wife is pretty concerned, while I tend to think we can take enough precautions to avoid any issues but also terrified of making the wrong decision with my child.

Bad **** happens to good people. Life can end like that, but we can't go all howard Hughes. I always wash my body with tea tree soap after bjj...**** can kill you.

To clarify, we had no intention of the toddler swimming, just playing the sand. And the burn is currently a dime sized blister. Trying to not be someone who is irrationally fear but also just not that familiar with the coast.

https://www.victoriaadvocate.com/news/health/man-dies-of-vibrio-infection-contracted-while-fishing-near-palacios/article_c60eeaa2-a977-11e9-a5e5-534552882acd.html

http://baycitytribune.com/community/article_41cf20c0-aa50-11e9-bba6-bb27a06f32e2.html

Second death.

If any doctors are reading this thread, here's a question.

If you shower and wash down with Hibiclens prior to getting in the water, it sounds as if the Hibiclens remains on the skin for up to 24 hours. Could this actually help prevent the infection from getting started ?

LoudestWHOOP! said:

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Stories like this make me wonder how I survived my youth.
Was this stuff around in the 1970-80s in Southeast Texas?

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In Fulton in the 80s whenever my brother or I got a cut my mom would always tell us to go "wash it in the water, the salt is good for it"

speckledtrout said:

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If any doctors are reading this thread, here's a question.

If you shower and wash down with Hibiclens prior to getting in the water, it sounds as if the Hibiclens remains on the skin for up to 24 hours. Could this actually help prevent the infection from getting started ?

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This sounds like a smartass answer, but I promise it's not....but yeah, I think that's the point of using the Hibiclens. Not only does it kill the stuff but leaves a residue behind.

AgsMnn said:

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How soon do symptoms start if exposed?

Asking for a friend.

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Both people that I know who got it threw up within 12-14 hours. They both had swelling in a concentrated area, redness and chills. If you feel anything out of the norm within 24 hours of being in water I would go get checked out. The doctors for one of the guys said he shouldn't be alive.