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Woman Has Arm, Shoulder And Breast Amputated After Bath Salt Injection

Mon, 01/16/2012 - 5:23am

A New Orleans woman who experimented with bath salts was ravaged by flesh-eating bacteria that caused an infection leading to the amputation of her arm, shoulder and breast, and nearly took her life. The 34-year-old woman showed up at a 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 a party, according to a case report published online in the journal Orthopedics.

Doctors gave her antibiotics for a skin infection, but two days later she 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. 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 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.

“As bath salts gain popularity, medical centers of all disciplines must be prepared to identify not only the signs of intoxication, but the potential side effects, including deadly necrotizing fasciitis,” Russo said. Bath salts are being sold all over the U.S. with names like “Ivory Wave,” “White Lightning” and “Hurricane Charlie.” They are not the type of salts you would add to your bath, however; these so-called bath salts are intended to be snorted, smoked or injected. The Drug Enforcement Administration does not regulate these substances, but they are under federal scrutiny, as the effects are comparable to methamphetamine abuse, according to poison control centers and other law enforcement agencies.

The powders often contain mephedrone and methylenedioxypyrovalerone, also known as MDPV, and can cause hallucinations, paranoia, rapid heart rates and suicidal thoughts, according to authorities. State lawmakers have been proposing to ban the sale of the powders. In Louisiana, the bath salts were outlawed by an emergency order after the state's poison center received more than 125 calls in the last three months of 2010 involving exposure to the chemicals.

A small packet of the chemicals typically costs as little as $20.

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