Eaten alive: Woman survives 5-year battle with flesh-eating germ

Waking from a fog of anesthesia, Sandy Wilson found she was a patient in one of the hospitals where she worked as a nurse. She remembered having a baby, and being told she had gotten an infection. But nothing could prepare her for what lurked beneath the sheets. w Flesh-eating bacteria were eating her alive. w "When I looked down at my belly, basically all the skin was gone and I could see my internal organs," she said. "I remember seeing my intestines. I thought, 'There's no way I can live like this. ... This is a death sentence.'"

In all of medicine, few infections are as feared as this one. It strikes out of the blue, especially obese people, diabetics, cancer patients, transplant recipients and others with weak immune systems -- a growing group of Americans. It kills 20 percent of its victims and horribly disfigures others.

It used to be caused almost exclusively by one type of strep bacteria. Now there's a scary trend: Drug-resistant superbugs like the staph germ MRSA increasingly are able to make "flesh-eating" toxins and cause nightmarish infections like Wilson's.

To treat it, doctors cut away dead tissue, but the infection often advances after they think they've gotten it all.

Inch by inch, it devoured the 34-year-old Wilson. Spleen, gall bladder, appendix. Part of her stomach and ultimately, all of her intestines.

This April 2005 photo provided by Sandy Wilson shows her with her newborn son Christopher in the intensive care unit at Anne Arundel Medical Center in Annapolis, Md. No one knows how Wilson got the flesh-eating bacteria, necrotizing fasciitis. In all of medicine, few infections are as feared as this one. It strikes out of the blue, especially diabetics, cancer patients, transplants recipients and others with weak immune systems _ a large and growing group of Americans. It kills 20 percent of its victims and horribly disfigures others. (AP Photo/Sandy Wilson)

Over five years, she had countless surgeries. For much of that time, she lived in hospitals and rehabilitation centers, fed by tubes and unable to care for her son. She lost her marriage and endured unimaginable pain.

"It was like I was rotting from the inside out," she said. "It felt like things were just being ripped out of me.

No one knows how Wilson got necrotizing fasciitis, the infection's formal name. The ordeal began after her son, Christopher, was born by Caesarean section in 2005. She developed a clotting problem and was given blood components pooled from hundreds of donors.

After several weeks, she went home but lasted only two days. Fluid built up around her C-section and her blood pressure plunged. She sought emergency care at an Annapolis, Md., hospital and was rushed into surgery, but doctors quickly closed her up once they realized what she had.

They sent her to Baltimore's Shock Trauma Center, a state-of-the-art hospital specializing in the most life-threatening cases.

"I remember vividly" how sick she was, said Dr. Thomas Scalea, Shock Trauma's physician in chief. "Some people don't live. Sometimes you do the best you can do and the disease is bigger than the medical care."

For two weeks, Wilson was kept sedated while surgeons sliced away rotten tissue and drained vile fluid.

"I can't tell you the number of times I operated on her; probably 40, 50 times," Scalea said. "Every time we went back, we just hadn't gotten control."

Once Wilson was stable, the doctors gathered her family to wake her and break the news. But the germs had only just begun to ravage her.

That fall, as she was being discharged from a rehabilitation hospital, she fell ill again. She had developed fistulas -- holes in her bowel that let its contents leak out to her skin. She spent the next two years in Shock Trauma or the rehab hospital, trying to heal those open wounds.

For Wilson, life was bleak.

"I was in pain all the time" and nauseated from the pain medicine, Wilson said.

Wilson's large and bizarre wounds "broke my heart," said her mother, Dottie Howarth, also a nurse. "There would be nights when we would sit with her and she would have so much pain, she'd say, 'I don't know how much longer I can do this.'"

Her health worsened. By December 2006, only inches remained of her small intestine and she developed liver problems. The only solution was risky: a small bowel transplant.

Of the nearly half a million transplants done since 1990 in the United States, fewer than 2,000 have been small bowels. Five-year survival rates are around 54 percent, and these transplants carry a higher risk of rejection than many other types.

Dr. Cal Matsumoto evaluated Wilson for one at Georgetown University Medical Center.

"I remember taking the dressing off. All you see is bowel with holes in it, like a bunch of worms coming out of your abdominal wall," the surgeon said.

The transplant came Dec. 16, 2007, and seemed to be a success. Doctors wound up transplanting a large intestine, too, because the damage was so extensive, Wilson said. A month later, she devoured her first meal since May 2005: lasagna, zucchini, salad and cake.

But it was too much too soon. She got peritonitis, a serious inflammation, and had to go back on tube feeding. Doctors took food much more slowly, and she can eat normally now.

Wilson went home for good at the end of January 2008. She's been hospitalized a few times since to make sure fevers were not a sign of organ rejection. She has had surgeries to graft skin and to connect the transplanted bowel to what remains of her colon so she would no longer need to wear a bag to collect waste. The last of these operations, everyone hopes, was in February.

"My life now is pretty normal. I am enjoying spending every moment I can at home with my son," Wilson said.