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Mazzystr
Gym climber
Homeless...
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Topic Author's Original Post - Oct 12, 2008 - 02:37pm PT
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Any know anything about mysterious bacterial infections in yosemite?
We were in the valley for the last 11 days. last week monday my buddy complained about feeling like his arm was badly bruised or broke. We had just climbed Nutcracker and he got the Pitch2 5.7 offwidth pitch. We all shrugged it off thinking well maybe he did some kind of wierd offwidth move that tweeked his elbow and arm. A couple days went by and he complained more and more and we postulated tendon or muscle tweak, microfracture, etc. By weds he was feverish and migraine headachy. He couldn't stand the pain so he went to the Yosemite hospital. His arm was swollen and puffy from mid upper arm down to his hand. his elbow was black and appeared bruised. The nurses said his elbow was full of fluid. They put him on a 24hr antibiotic. 24hrs later he was in worse shape. The infection expanded about an inch and a half beyond the previous infected area. They put him on a different antibiotic administered through IV. He went through two treatments before we had to leave yesterday morning.
We arrived back in NC last night 11pm and he went to the local hospital ER. They admitted him immediately. His infection has spread another inch beyond the marked region despite heavy duty antibiotics. His whole arm is now swollen to twice the size of a regular arm.
I can think of a few scenarios that he could have gotten an infection like this...
1 - he got chewed up a bit on the Nutcracker offwidth. Someone pissed or shat down the crack from the p2 belay platform.
2 - he got chewed up a bit on the Nutcracker offwidth and he put his arms on the nasty picnic table at Camp4 and picked something up there.
3 - he got chewed up a bit on the Nutcracker offwidth and we went to the curry showerhouse and he picked up a bug up there. I know the showerhouses are gross but are they that gross? but who knows what goes on behind curtain...
4 - he got a bug bite? but he would notice right away if it was a spider or snake bite, right? like "FK! what the FK was that???" kind of noticing.
possibly 5 - hes into tatoo's and he picked something up before going to the valley and it exploded while we were out there.
Has anyone heard of a similiar case? any advice? I know I know amputation is always the cure but this is my buddy and climbing partner. I'm getting worried for him that he my loose the arm and I don't want that to happen to my friend and climbing partner.
Thanks,
/Chris C
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jstan
climber
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Oct 12, 2008 - 02:55pm PT
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Brown recluse spider bite?
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Mazzystr
Gym climber
Homeless...
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Topic Author's Reply - Oct 12, 2008 - 02:58pm PT
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are they around this late in season?
/chris
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Indianclimber
Trad climber
Lost Wages
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Oct 12, 2008 - 03:02pm PT
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Some bites you don't feel when they happen,specially
if your busy chewing up your arms in an offwidth
This is a scary scenario hopefully someone here can help
Best of luck
Ninfa
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Indianclimber
Trad climber
Lost Wages
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Oct 12, 2008 - 03:04pm PT
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Brown recluse info
Brown recluse bites may go unnoticed for a period of time, or the person might begin to experience an itching or burning sensation as early as 30 minutes from the time that they were bitten. Typically, within eight hours a necrotic spot may develop which can enlarge to the size of a silver dollar or larger. If these symptoms appear, then the area can become sunken and ulcerated. Some reaction may or may not occur with these bites, typically there can be a fever, severe chest or stomach pain, nausea and/or vomiting
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Mighty Hiker
Social climber
Vancouver, B.C.
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Oct 12, 2008 - 03:05pm PT
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Has the hospital done any blood or other tests, to determine what it is? Presumably they believe it's a bacterial infection, or they wouldn't be giving him antibiotics.
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Mazzystr
Gym climber
Homeless...
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Topic Author's Reply - Oct 12, 2008 - 03:16pm PT
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the nurses called is cellulitis. its been a week and his symptoms are swelling, redness and soreness in his arm and fever and nausea. if it was a brown recluse bite then the surrounding tissue would be decomposed and it'd be all gross.
he has had three doses of amoxicillin administered through IV. I don't know what he's on right now but the mox was supposed to be the "Mother of all Bombs" when it comes to infections.
i'll keep you guys updated on his condition.
/chris c
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paganmonkeyboy
climber
mars...it's near nevada...
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Oct 12, 2008 - 04:03pm PT
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damn - i hope he kicks it...scary...
-tom
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Michelle
Trad climber
El Frickin' Paso
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Oct 12, 2008 - 04:23pm PT
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ouch, that sounds like no fun. Is he suffering from compartment syndrome too?
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Mazzystr
Gym climber
Homeless...
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Topic Author's Reply - Oct 12, 2008 - 04:55pm PT
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Jezez! Thanks for the update Karl!
I will relay the information.
/Chris
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BurnRockBurn
climber
South of Black Rock City
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Oct 12, 2008 - 04:55pm PT
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Agree with Karl. We see those type of infections in the ER all the time. Nasty if not treated right away. Unfortunately getting more and more common even for healthy people. Best of luck on the treatment.
BRB
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Mazzystr
Gym climber
Homeless...
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Topic Author's Reply - Oct 12, 2008 - 05:19pm PT
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I just spoke with Rush. He is being moved into surgery. They think the source of the infection is that sac of fluid in his elbow. Remember we are in North Carolina and these f*#kers don't know how to count to 10...just look at Concourse C in Charlotte Douglas Airport and he [spelling correction] is not at the prestigious Duke University hospital system. My worry is upped another notch.
I gave him the information regarding the MRSA infection to relay to doctors.
I'm on my way to the hospital. His family is all 4hrs away. I'll update when I can.
Thanks,
/Chris
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Karl Baba
Trad climber
Yosemite, Ca
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Oct 12, 2008 - 05:40pm PT
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"They think the source of the infection is that sac of fluid in his elbow."
It was a sac of fluid that they had to remove from my Mom's knee.
Hope the docs find the problem, whatever it is
peace
Karl
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nick d
Trad climber
nm
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Oct 12, 2008 - 05:48pm PT
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I had a similar infection several years ago. I damaged the bursa sac in my elbow manteling. Payton Manning just had to have a surgery for removal of the bursa in his knee. I think it is a pretty common scenario.
All of us are covered with staph bacteria and all it takes is a miniscule hole in your skin to get it inside. The fluid in your bursa is a perfect culturing material. Good luck to your friend, I hope he makes a complete and swift recovery.
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ec
climber
ca
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Oct 12, 2008 - 06:06pm PT
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O/W???????????????
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Bullwinkle
Boulder climber
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Oct 12, 2008 - 06:11pm PT
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yeah!!! What 5.7 offsize? where?on the Nutcracker? all these years and I've missed it?
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Brock
Trad climber
RENO, NV
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Oct 12, 2008 - 06:15pm PT
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hope it is not fascitis..
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neebee
Social climber
calif/texas
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Oct 12, 2008 - 07:27pm PT
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hey there mazzystr... say, i saw this too late to help do any "before praying", but i can pray now, for whatever is still going on...
say, a co-worker at the cat/dog shelter had some small itch, or ache and pain, and just ignored it for a few days--as she does already have other health trouble as to neck pains, etc...
well...... her husband took her into the hospital finally, cause she could not walk... just after they arrived, the area swelled up hugely and was all red, and infected..... her lower leg got huge but the DID stop the infection from traveling any further into her body....
seems it had started from the hip area, and moved down...
she showed up pictures of her leg and it was swellled, and looked all bruised up after all this...
some infection was all they could come up with, antibiotices, etc, while in the hospital, was what was done for her...
she is well now....
say, i am very sorry to hear this for you buddy... i will really pray too, hope that there is still some kind of a good intervention that can come to him....
(her trouble may have started from a flea bite area, OR MAY NOT have... ) no one really knows...
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neebee
Social climber
calif/texas
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Oct 12, 2008 - 07:37pm PT
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hey there mazzstr... say, after someone a "bit above my post" mentioned this: fasciitis...
here is a link to this:
http://en.wikipedia.org/wiki/Necrotizing_fasciitis
*there is some more links if you scroll down, of well-known folks that have had this happen, and the results...
some ranging from recover, others amputation or removal of large parts of area, and some, even died...
:(
*please let us know how your friend is doing, we are all rooting for him, and feel very sad that his wonderful trip turned out so terrible ....
god bless, and prayers for way for both of you...
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stevep
Boulder climber
Salt Lake, UT
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Oct 12, 2008 - 07:42pm PT
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Sounds pretty extreme for a spider bite. More like a bacterial issue like MRSA. Not usually found outdoors, but the showers would be a possiblity.
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enjoimx
Big Wall climber
SLO Cal
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Oct 12, 2008 - 07:56pm PT
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OW on pitch 2?
On Nutcracker?
Nutcracker?
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Anastasia
climber
Not there
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Oct 12, 2008 - 09:47pm PT
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Wow... I am wishing him a full and quick recovery. Scary stuff, especially when it just hits you out of nowhere.
AF
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Mazzystr
Gym climber
Homeless...
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Topic Author's Reply - Oct 12, 2008 - 09:51pm PT
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I just got back from the hospital.
There has been no spread of the infection up or down his arm. he is in really good spirits. We all had a healthy discussion about that dumbass rap bolting half dome, lol!
The docs say the same thing about the mrsa bacteria. They think he hasn't been on antibiotic long enough to have an effect so they're putting him through another cycle. Tues they will open his elbow to drain the fluid.
Rush thanks everyone for the support and advice. So do I.
/Chris C
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Mazzystr
Gym climber
Homeless...
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Topic Author's Reply - Oct 12, 2008 - 09:59pm PT
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I have to make a correction.
He was given amoxicin orally last week then he was given vancomoxin via IV on friday night and saturday morning and this morning with no change in the infection.
I got all the cin's backward after 20hrs of travelling...
I'll update when/if I hear something.
Thanks,
/Chris
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Brock
Trad climber
RENO, NV
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Oct 12, 2008 - 10:03pm PT
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Ebola? think da Valley should be quarantined so i can climbed all by myself in a viral safe bodysuit approved by the CDC
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Mazzystr
Gym climber
Homeless...
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Topic Author's Reply - Oct 12, 2008 - 10:08pm PT
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Nutcracker -
go up the 5.9 finger crack that is to the right of the standard start scramble. you know? the crack that you always look at but can't climb? yea that one. LOL! just kidding about that!
Anyways, go up the 5.9 finger crack. Belay at the second tree. The 5.7 fist and off hands is past the third tree just below the P3 platform.
/Chris C
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Peter Haan
Trad climber
San Francisco, CA
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Oct 12, 2008 - 10:38pm PT
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Mazzy,
It's really impressive that you are so powerfully involved helping your friend. What a climbing partner! Thanks for sharing your dilemma here and wishing you two the best. And it sounds more like toxicity than infection.
ph
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freefall
climber
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Oct 13, 2008 - 12:23pm PT
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Man, I'm real sorry to hear about this, I had high hopes for your trip to the valley. Everyone here at TRC wishes Rush the best and will keep him in our prayers. I'll try to get over there today. Thanks for keep us informed.
The TRC crew
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healyje
Trad climber
Portland, Oregon
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Oct 13, 2008 - 12:48pm PT
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Just a note that our bodies are inherently filthy with all manner of opportunistic bacteria that, under just the right circumstances, can guickly get wildly out of hand. CMRSA or MRSA are certainly a possibility, but only two of many. I do very much doubt this has anything to do with a 'novel' bacterial in the Valley.
A few years back I had a friend get lightly knicked in the ankle by his fin while windsurfing in the Columbia River Gorge, which is not all that uncommon an occurance. One thing led to another and before it was all over he ended up with his leg laid open from ankle-to-crotch down to the bone, airing it out for gangrene. Once they put it all back together it looked like the Rift Valley running down the inside of his leg - not pretty.
These kinds of infections can be tough to pin down and also be hard to identify by stain or culture - which the docs can't wait for anyway. Seems like your friend is getting the canonical treatment - hopefully he'll respond well with it. It also sounds like good news if the infection isn't spreading further.
Good on you for being such a fine friend and best of luck to your partner.
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micronut
Trad climber
fresno, ca
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Oct 13, 2008 - 01:04pm PT
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Hey man, I hope your buddy is on the way to a full recovery soon. Just a couple things.
1. There are NO brown recluse bites in California.
They get diagnosed by uneducated MD's all the time in ERs, but there are no brown recluses here and never have been, though everybody seems to know "an uncle who got bitten by one and almost died." Here is a great link to all the myths surrounding this little "bug." http://spiders.ucr.edu/myth.html
2. Sounds like MRSA or cellulitis and it can be impossible to find the origin. Often healthy people get these scary infections from minor trauma ( imean minor, like buping a knee on a coffee table)and they can be quite destructive. As long as his team of docs keeps this at the top of their differential diagnosis he should be ok, but they need to go after it hard. None of this "lets wait and see for a couple weeks" stuff.
Again, hope he mends soon. Bummer for such a thing to happen in such a great spot as the Valley. Hope you guys had a good time out here.
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SteveW
Trad climber
The state of confusion
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Oct 13, 2008 - 01:26pm PT
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Hope all's going better with that nasty infection.
And kudo's to you for stickin' with him through this
tough time.
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Mazzystr
Gym climber
Homeless...
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Topic Author's Reply - Oct 13, 2008 - 01:54pm PT
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I spoke with Rush today on IM....damn iPhones. Theyve freed people from computers! He sent a picture of his hand. It is a much more normal looking hand. He also said they did full blood work and confirmed MRSA.
I noticed last night that I have a pinky finger nail size lump on my forearm that resembles a mosquito bite but bigger and harder. its still there today. i dont have any pain or fever or headache so I hope that that is all it is.
/Chris
ps...Hellz yea! TRC representin on the taco, YO!
pss...PeterHann, thanks for the compliments. I feel kind of bad for 2reasons. 1, I hyped up Yosemite by talking about how awesome the place is and the people are and 2, I kind of shrugged him off at first. so i feel a bit guilty and at fault for all this biznizz
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micronut
Trad climber
fresno, ca
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Oct 13, 2008 - 02:01pm PT
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Dude keep a CLOSE eye on that thing. mrsa is VERY contagious....very. The fact that you were in close quarters with him and he has a diagnosed case of it should not be ignored. If that thing doesn't go away asap, you gotta have it looked at. DO NOT mess with this stuff. Take care.
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HighDesertDJ
Trad climber
Arid-zona
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Oct 13, 2008 - 02:05pm PT
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Dunno how I missed this thread last night it's a good one! MRSA is pretty much every provider's top concern and you need a pretty solid dose of Vanomycin to knock it down.
Your buddy did not likely contract MRSA from the rock itself. Either he or someone he can into recent contact with (perhaps even yourself) has MRSA colonized in your nose and some snot made its way into his wound. Someone wiped their nose or sneezed on some carabiners or whatever, then he touched them and then touched his wound. His body couldn't fight it off (cause of all that heavy drinking) and then it turned into a full blown infection.
Note that MRSA typically takes 4-5 days to turn into a recognizable infection. I'm not sure if this falls into your timeline or not, but he could have had it brewing well before you guys climbed that crack.
When you said it was growing it sounded like necrotizing fasciitis, but it wasn't moving quickly enough. Necro is caused by strep mutations that simply live on the skin or in the throat and mouth. Infections can be caused by even the smallest of breaks in the skin. A physical therapist here in Flagstaff apparently got it from shaving her vagina and then shaving her armpits. The necro moved on the razor from her vagina and then was introduced into her body by a micro cut on her armpit. She died in a helicopter being flown down to Phoenix for treatment.
That's great they figured out what it is so that they can take care of it. It might be worth it to your crew to get checked for MRSA colonies in your nose. Some hospitals have instituted policies swabbing every single nose of every single admitted patient in an attempt to knock out the MRSA colonies in their communities. MRSA is very contagious but it only actually harms a small percentage of the people who have it. There are people reading this forum right now who have it living in their nose and are healthy as can be.
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rush
Trad climber
NC
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Oct 13, 2008 - 03:04pm PT
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So after a few days in the valley clinic and a couple of days back on the east coast in a local hospital the doctors have determined that it was in fact MRSA. I think Karl Baba had suggested this earlier in the thread. Anyhow this strain of staph is not to be taken lightly and it is fairly communicable (more so than a typical infection) and there are only two antibiotics that will treat it.
A few people have mentioned having picked this up in the valley, so a word to the wise if you think you may have an infection go to the clinic and have it looked at. Everyone at the clinic is amazing.
Luckily I was able to catch it soon enough that I may not have to undergo any surgery, although there has been discussion. I have been hooked up to two extremely potent antibiotics on drip for the past three days and my forearm and hand have almost deflated back down to the original size. The only major concern at this point is the fluid in my elbow.
Thanks for all the support guys.
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HighDesertDJ
Trad climber
Arid-zona
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Oct 13, 2008 - 03:50pm PT
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MRSA isn't any more communicable or virulent than any other form of Staph. It's just resistant to the most commonly used (and least harsh on our bodies) antibiotics.
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dr. jay
climber
petaluma, ca
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Oct 13, 2008 - 05:03pm PT
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MRSA is a mutated version of the Staph Aureus bacteria that has been around for quite a long time but within the last few years has become wisespread throughout the population. the MRSA in the coummunity setting (c-MRSA) however is a completely different entity than what you would pick up in the hospital, nursing home, etc. (h-MRSA). the c-MRSA is much more virulent than non-MRSA in that people with normal immune systems can still get significant infections.
previously it would only cause problems in immune-compromised individuals, and if a normal person got an infection it was easy to treat with the usual antibiotics (Keflex, Dicloxacillin, Amox). when people started failing the usual treatment and having serious complications everyone realized things had changed, but much of the hype and hysteria was based on a few individual cases and not what was found in common practice. the c-MRSA is easily treated with the proper antibiotics and treatment (including draining abscesses).
many problems still arise when the wrong medicine is chosen, but since at least 60% of soft tissue infections now are MRSA, it shouldn't sneak up on any practitioner. also good wound care is really important. Mazzy's partner chewed up his skin on the rock so now it wasn't doing its thing to keep out all the nasties, and since the vally is a veritable petri dish (and proper sanitation isn't really possible) there is bound to be colonization picked up in a public place. once the bacteria gets past the barriers it can really go to town on your body in a hurry. the good news though is that it will heal fully without any significant sequelae (other than cosmetic perhaps) but there's no reason your man shouldn't be out climbing again down the road. good luck.
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Patrick Sawyer
climber
Originally California now Ireland
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Oct 13, 2008 - 05:20pm PT
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Back in February 1993, I noticed that my right elbow was becoming a bit swollen. So I saw a doctor and he prescribed me antibiotics. The next day he got a hold of me and wanted to admit me to the hospital (Contra Costa Hospital in Martinez).
I spent eight days there. The elbow and lower arm had swollen quite large. The diagnosis was cellulitis. I was on an IV drip all that time. One of the hospital doctors said that if the infection had reached my heart, it could have been potentially fatal.
Several days earlier, prior to the infection, running and playing with my dog, I fell and slightly scratched my right wrist, a minor abrasion to say the least. However, that appears the only cause of the infection.
BTW, MRSA is becoming a problem in Irish hospitals.
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dougs510
Social climber
down south
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Oct 13, 2008 - 08:01pm PT
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Sheeww... Man, I'm glad your doing better dude. Scary stuff. I wonder where you picked it up at... C4, CVillage showers? Got any idea?
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McC
Trad climber
Livermore Ca
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Oct 16, 2008 - 11:57pm PT
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Best of luck to your buddy. Infections can be serious and are not fun. Suggest he ask his doc about Invanz, if the infection recurs.
I went through lots of antibiotics in 2006 prescribed by my doctor, before an Infectious disease specialist in December 2006 prescribed 6 weeks of 1x per day intravenous drip of Invanz (self administered).
Whacked my right elbow in late June 2006 in Peru, barely breaking the skin under my fleece and shirt. One climb and 4 days later, the pain, fever, and hallucinations on the flight home were intense. According to my doc and the lab, it was "just" Staphylococcus aureus from my skin and not MRSA. Chipped elbow, bursitis and bone infection. I took 2 weeks of Cipro. Still infected. This was followed by 6 weeks of Augmentin. In August, back to Cipro. Elbow got better with time, but swelled with moderate use.
In late November 2006, I third classed a fine ice and snow gully on the Wheeler Crest with one of my brothers. The recovering elbow functioned ok until I slipped on the icy trail (ouch!) on the hike out -- resulting in a highly swollen (within hours), re-infected and draining (within 24 hours) right elbow. MRI showed bone involvement (again), osteomyelitis at triceps tendon attachment point, infection of the bursa, and cellulitis. Infectious disease doc listened to my recounting of events, reviewed the lab test results, and prescribed the daily IV of Invanz via a PICC line in my forearm.
Peru trip report:
http://www.rock-ice.com/index.php?option=com_content&task=view&id=129&Itemid=48
-or-
go to this site:
http://www.rock-ice.com/ -and- do a search for "PeruPeru"
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Jaybro
Social climber
wuz real!
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Oct 17, 2008 - 12:24am PT
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Is this what almost killed* Platinum Rob a while back?
* as I remember he got an ankle goby on Liquid Sky, 12/24/19?? then got it infected in the "leach fields, below El Cap" somewhat later, life saved by anibiotics at the valley clinic when the red streaks began to sprint toward his heart.
-or similar.
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David Nelson
climber
San Francisco
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Oct 17, 2008 - 12:31am PT
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I agree with Micronut, there are no brown recluse spiders in California. I researched this out for my ER recently, spoke with a spider expert at UC Davis who specialized in brown recluse spiders. He stated that the only brown recluse spiders (Loxoceles reclusa) in CA are the ones that come in on shipments of lumber, household moving boxes, and such. (The condition of being bitten by a brown recluse is called loxocilism, due to the genus name. Just thought you might like to know.) The course is also not at all typical for a spider bite. It is a bacterial infection. A spider bite should develop, in time, a necrotic (dead) center, if it is serious.
MRSA stands for methicillin resistent staphylococcus (shorthand is "staph") aureus, meaning it is a staph aureus bug that has developed (calling it "mutated" is correct but not proper use) resistance to the drug methicillin and by implication, resistance to the line of penicillins, both natural and synthetic. We need to treat it with a non-penicillin type drug. Bactrim by mouth and vancomycin by IV are standard treatments. They are no more contagious, as has been stated, just very resistant and aggressive.
(I am an orthopedic hand surgeon, so I have to deal with these from time to time. Does not mean I am right, but I have studied it a bit, and you might say that my beta comes from having done the route, so to speak.)
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Dr. Rock
Ice climber
http://tinyurl.com/4oa5br
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Oct 17, 2008 - 01:30am PT
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Bad news to take a fall and scratch your leg open out in the boondocks.
If you have packed in, getting out on a leg swollen up to the size of a grapefruit....wait.
Grapefruit does not work here.
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healyje
Trad climber
Portland, Oregon
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Oct 17, 2008 - 03:37am PT
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Likely worse news to take a fall and scratch your leg open in a crowded urban gym...
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HighDesertDJ
Trad climber
Arid-zona
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Oct 17, 2008 - 05:12am PT
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Hey that's cool. I didn't realize that CA MRSA was that much more virulent.
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JuanDeFuca
Big Wall climber
Stoney Point
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Oct 17, 2008 - 01:31pm PT
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So was it some type of Staff Infection?
Juan
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Crimpergirl
Social climber
Boulder, Colorado!
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Oct 17, 2008 - 02:36pm PT
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Glad to see you are doing well!
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randomtask
climber
North fork, CA
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Oct 17, 2008 - 05:00pm PT
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MRSA might not be happening at such an alarming rate if we didn't have antibiotics in most of our cleaning supplies and doctor's over prescribing them ( look, I know that it isn't Doctor's faults-if they don't give someone antibiotics and they die they get their asses sued hard). But still-don't buy antibacterial soaps for household use. Mechanical action and emulsion (due to the fat in soap) will sufficiently get rid of any household bug. And don't take them if you know you don't need them-listen to your body.
-JR
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Dr. Rock
Ice climber
http://tinyurl.com/4oa5br
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Oct 17, 2008 - 06:22pm PT
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Beans and Bacon, lets eat!
Not now Hoss, we got work to do.
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dr. jay
climber
petaluma, ca
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Oct 19, 2008 - 09:53am PT
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the ca-MRSA bugs are more virulent because they have developed a toxin that can break down a normal host's defenses that prior s. aureus could not. the toxin also causes a major inflammatory response so these infections are incredibly painful.
and about spider bites--when a patient says they were bitten by a spider they have more than triple the likelihood of a MRSA infection. i don't know why everyone picks on spiders, must be some innate arachnophobia humans have or something.
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johnboy
Trad climber
Can't get here from there
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The last few years I noticed my lungs getting weaker. After many regional doctors couldn't figure it out I opted to go to the University of Minnesota Hospital in Minneapolis. They found I had a a mycobacterium parascrofulaceum infection. Scary sh#t. I've been on a high daily regiment of antibiotics for almost a year now and still feel like I'm not quite winning the battle. They mix up my antibiotics every now and then as this thing can easily mutate.
I sure hope your virus in Cali isn't as bad and none of you catch it or any other viruses.
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Kalimon
Social climber
Ridgway, CO
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Thanks Ed . . . fantastic information.
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rottingjohnny
Sport climber
Goldenville west of Lurkerville
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Some of those bacteria have been traced back to Werners van...
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