In December, the Crenshaw family came down with the flu. When Bryson, then 3, began to feel sick, his mother, Megan Crenshaw, thought he had a virus and gave him Tylenol. Then Bryson complained of muscle pain.
"He just said, 'Mom, my leg hurts a little.' And I would rub it," Megan Crenshaw, 35, of Lafayette, Indiana, told TODAY.com. “That night my husband and I decided to take him to the hospital and he wanted me to carry him.” The Crenshaws soon learned what was going on: Bryon had necrotizing fasciitis, also known as flesh-eating bacteria.
“We didn't know what necrotizing fasciitis was. We'd never heard of it, never met anyone who had it," says Megan Crenshaw. "Let our son get the rarest disease I've ever heard of and now let's go on that journey."
lethargy and leg pain
When Bryson complained of leg pain that didn't seem to be getting better, his parents rushed him to the emergency room. His symptoms worsened rapidly.
"The doctor came in and noticed that he wasn't putting any weight on his leg. So the doctor asked him, 'Does your leg hurt?' And he said, 'My knee hurts.' And he rubbed his leg." recalls Megan Crenshaw. "I told him, 'He was complaining a little bit about his leg hurting, but I didn't see anything.' He hasn't fallen or anything lately."
The Crenshaws mentioned that their family recently had the flu and they thought Bryson had it too. But the doctor noticed that Bryson's knee was swollen, and she took an X-ray. Her parents thought she might have hurt her knee jumping off the couch or skipping a few steps while she was running for them. The doctor knew immediately what Bryson had.
"He showed me where on the x-ray there was something blackish, almost like a blackness, and he said… 'It's necrotizing fasciitis,'" says Megan Crenshaw. "He said, 'It's a very rapidly progressing soft tissue infection. It can be fatal.'"
The Crenshaws were stunned by the news.
"It was like, 'What the hell is this? How did he get it? Do we have to move? Is he in our house? Should we be worried about our other son? We need more information. Is he contagious?' says Megan Crenshaw. "(There were) so many thoughts going through our minds."
Bryson had to be transferred to Riley Hospital for Children in Indianapolis. Doctors deluged the family with questions: Did his dog bite or scratch Bryson? Did you swim in a stream or in contaminated water? Had he done anything out of the ordinary lately?
"I'm a helicopter mom," says Megan Crenshaw. "All the answers were 'no', so we were a bit puzzled."
As soon as he got to Riley, the doctors took him back for another scan to understand where the infection was. He soon underwent surgery to remove the infected tissue from his leg. A second scan showed that the infection was advanced.
"It looks like the infection is spreading to her hip and stomach...and she had some (dead) tissue in her small intestine, her colon, and they had to have her appendix removed as well," Megan Crenshaw explains.
Bryson underwent a second operation within 24 hours to allow doctors to remove dead tissue from his abdomen and appendix.
"There's nothing you can do. As a parent, you just want to protect your children," father Ben Crenshaw tells TODAY.com. "It was like you hit the reset button on your life."
Necrotizing fasciitis treatment
Necrotizing fasciitis is rare. About 700 to 1,500 people are infected with necrotizing fasciitis in the United States each year.Centers for Disease Control and Prevention.
"Necrotizing fasciitis is a very rare condition, especially in a child that age," says Dr. Christine Caltoum, medical director of surgical operations and division manager of pediatric orthopedic surgery at Riley Children's Health, who was involved in the care. of Bryson, he told TODAY.com. "We tend to see a case of necrotizing fasciitis maybe every year or two, and the disease severity of it is much greater than what we normally see in these cases."
While a variety of bacteria can cause it, experts believe so.group A strepis the most likely culprit behind necrotizing fasciitis, thedice CDC. Group A strep infection usually causes mild symptoms, such as strep throat or impetigo, a bacterial skin infection. But when the infection becomes invasive—meaning it spreads to the part of the body it doesn't normally reach—it can cause serious illnesses, including necrotizing fasciitis, pneumonia, and strep toxic shock syndrome.
In December 2022, around the same time that Bryson developed his infection, the CDC warned of an increase in cases of invasive group A strep in young children. Two American children died from invasive strep between October and December of last year. The CDC recently reported that the reason for the increase in invasive strep A was likely last fall.Increase in respiratory viruses in children.
“Anytime we see a large number of respiratory viruses, we know we're going to see an increase in bacterial infections,” said Dr. Michael Green, medical director of infection prevention and antimicrobial accountability at UPMC Children's Hospital in Pittsburgh, previously on TODAY. com.
The Crenshaws believe that Bryson had the flu just before he developed necrotizing fasciitis. People also develop flesh-eating bacteria when the bacteria enter through a wound, but Megan Crenshaw says she doesn't recall Bryson ever having cuts or scrapes.
"I had a very rapidly progressing case of necrotizing fasciitis," says Caltoum. “We commonly see bone and joint infections in children and most of the time they get it without us knowing why it is happening. Sometimes there may be pre-existing trauma, but in the vast majority of cases there isn't."
Doctors performed between 10 and 11 surgeries on Bryson, including surgeries on the abdomen, to try to stop the infection.
"The difficult thing about a lot of these cases, and Bryson's case, is that it's hard to know exactly where something started or ended," says Dr. Stefan Malin, an intensive care physician at Riley Children's Health who was involved in Bryson's treatment. on TODAY.com.
Ultimately, doctors realized they couldn't save Bryson's entire leg.
"The necrotizing fasciitis had progressed so fast," Caltoum says. “There was a lot of non-viable tissue in the leg. So a lot of dead muscle, a lot of dead areas that just couldn't be saved."
Doctors performed a non-traditional amputation in which one of Caltoum's associates removed dead tissue and bone and used healthy tissue and bone to rebuild his leg. The amputation is considered above the knee, but the use of some healthy tissue and bone from the lower extremity made it more stable.
"It gives Bryson a longer limb, if you will, so it's easier for him to wear the prosthesis in the long run," Caltoum explains. “We know that the children are doing very well. You are resilient. They learn all kinds of things: running, jumping, playing, playing sports with a prosthesis. So we have high hopes for him."
rehabilitation and home
On January 18, Bryson underwent amputation surgery. Before the procedure, a smart boy consoled his father.
"I sat there and held his hand and cried," says Ben Crenshaw. "He said, 'Why are you crying?' I said, 'I'm just worried about you.' He looked me right in the face and said, 'Stop crying. That'll be fine.'"
The Crenshaws were impressed that Bryson's medical team was able to use healthy muscle and bone from his lower leg to rebuild his thigh. Following this, Bryson underwent a skin graft from his left leg to his right to aid in healing. Subsequently, they performed needle aspiration to remove the accumulated fluid. Blood tests were done every few days to make sure the infection didn't spread further.
"The hardest part for us after the amputation," says Megan Crenshaw. "Why is he still sick?"
Little by little he got better.
“The food was better. The fever was better controlled,” she says.
Eventually, Bryson checked into inpatient rehab and did so well that he came home two weeks earlier than expected. Until he has his prosthetic leg, he uses a wheelchair and a walker. His parents have even seen him slide on his butt to move when necessary. The 4-year-old is "very independent" and isn't afraid to tell others what happened to him, his mother says.
"We actually went to church yesterday and a little boy came up to her and said, 'What happened to your leg?'" adds Megan Crenshaw. "Bryson said, 'Oh, I have an infection and [my leg] made me sick. So the doctor cut it off.'"
The Crenshaws hope that by hearing their story, other parents will encourage them to take action to protect their children's health. Taking Bryson to the hospital when they did probably improved his outcome, according to the doctors. The family is very impressed with their son.
"He's doing well. I'm so proud of him. Very proud of how far he's come," says Megan Crenshaw. "He's a fighter and he's determined."
This article was originally published onHEUTE.com
originally published