Bath Salts Linked to Flesh-Eating Infection

Mephedrone, in bath salts
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Use of bath salts can cause paranoia, suicidal thoughts, rage, hallucinations, and a dangerously rapid heart rate, and now researchers have added another condition to the list: flesh-eating infection. Investigators at Louisiana State University Health Science Center New Orleans School of Medicine report that bath salts were identified as the cause of deadly flesh-eating infection in a 34-year-old woman.

Bath salts use led to amputation

The report, which was published online in Orthopedics, describes a woman who went to the hospital complaining of pain and redness of her forearm, which also had a puncture wound. Doctors treated her for cellulitis with antibiotics, but even though her symptoms improved, the pain continued.

The patient admitted she had injected bath salts two days before she went to the hospital, and she was examined again. She had progressive redness, dead skin that was peeling off her arm, and drainage.

The doctor suspected necrotizing fasciitis, or flesh-eating infection. This condition typically first appears as “innocent” cellulitis or an abscess, even though rapidly progressing damage is occurring under the skin’s surface.

Surgeons attacked the infection immediately with debridement (removal of dead tissue) and antibiotics as the infection spread rapidly. To stop progression of the disease, surgeons must continue to remove tissue until they reach healthy tissue.

In this case, the surgeons had to amputate the woman’s arm, shoulder, and collarbone, and also do a radical mastectomy. The patient survived and underwent skin grafts and rehabilitation.

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Bath salts can be deadly
Unlike the traditional bath salts used to help soak away the day’s stress, illicit bath salts with names like “Hurricane Charlie” and “Ivory Wave” are injected, smoked, or snorted to get high. The powders typically contain mephedrone, methylone, and methylenedioxypyrovalerone (MDPV).

On October 21, 2011, the federal Drug Enforcement Administration (DEA) made it illegal to make bath salts in the United States and classified the three chemicals in the salts as Schedule 1 substances. The ban makes it a crime to sell or possess any of the three main ingredients.

However, the ban is only temporary and can last for one year. During that time, investigators will explore whether the drugs should be controlled by federal law permanently. The DEA then has the option to extend the ban for an additional six months.

Most states have enacted laws to ban the sale and possession of bath salts. The latest state to make that move is Delaware, whose Senate passed the ban on January 13, 2012, and sent the bill to the House for approva, according to Newsworks.

According to Russell R. Russo, MD, a third-year orthopaedic surgery resident who led the study at LSU Health Sciences Center New Orleans School of Medicine, “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” which can include flesh-eating infection.

SOURCES:
Drug Enforcement Administration
Russo R, Marks N, Morris K, King H, Gelvin A, Rooney R. Life-threatening necrotizing fasciitis due to ‘bath salts’ injection. Orthopedics 2012 Jan; 35(1): 124

Picture credit: Wikimedia Commons

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