The infection has spread
from a cut on her knee
to much of her body
How to identify, treat the diseaseBy Rod Ohira
Anthony Shimizu's police instincts urge him to do something, a life is at stake, but there's nothing he can do to help his critically ill 5-year-old daughter.
"I'm not deeply religious," Shimizu said, "but I've reached deep inside my soul to try and negotiate with the Man.
"Prayers are holding me together. I just can't believe this is all happening."
Necrotizing fasciitis, commonly known as the "flesh-eating bacteria," began ravaging the 34-pound body of the second youngest of Shimizu's five children a week ago today, less than 24 hours after Alyshia fell and cut her knee.
"She was playing in the garage, hanging on a clothesline that broke," said Shimizu, a Wahiawa resident assigned to HPD's East Honolulu patrol district.
A fund has been set up to help the Shimizus with medical costs. Checks payable to Anthony Shimizu Fund can be sent to the Honolulu Police Federal Credit Union, 1537 Young Street, 3rd Floor, Honolulu, 96826.
FUND TO HELP
"She came down on her right knee. I was sleeping and panicked when I heard her scream. I took her to Wahiawa ER and they cleaned it, gave her a shot to numb the area and stitched her up."
The following night, Alyshia began running a high fever.
"Her temperature rose to 101, 102 and kept climbing," Shimizu said. "And her knee swelled up so we took her back to the ER."
Shimizu and his wife, Annette, were advised to take Alyshia to their own physician, who was out of town. The physician handling their doctor's patients advised the Shimizus to take their daughter immediately to Kapiolani Hospital.
Alyshia was admitted to the hospital, where tests were taken on her leg.
"Two days later, her leg from ankle to thigh was twice the normal size," Shimizu said. "You could see her skin was stretched and getting tight. She couldn't move the leg, period.
"The tests results came back and they didn't tell us anything right away but I could tell from looking at the doctors it was something bad. I kept thinking, it was only a cut and we had it cleaned and stitched. What could it be?"
When told that Alyshia had necrotizing fasciitis, Shimizu was stunned.
"I just didn't think something like this could happen in this day and age," he said.
Alyshia was in surgery from late Friday night to early Saturday morning as doctors removed dead skin tissue.
The infection had spread from a one-inch wide cut on the knee, which had required five stitches to close, to over one-third of Alyshia's leg, from the calf to her thigh, Shimizu said.
A second surgery was performed 12 hours later to remove more tissue.
"I just couldn't believe how fast it was spreading," Shimizu said. "It was now up to her hip area, midsection and right side of her chest.
"She also started to hemorrhage. I kept thinking my daughter is bleeding to death. They put five pints of blood in her and five pints come out."
Doctors advised Alyshia's parents that there is no quick cure except surgical removal of affected tissue.
Alyshia has been in a clinically-induced coma to preserve her energy since the second surgery, Shimizu said."(Monday night) was my lowest point," he said. "Her left knee was showing signs of swelling.
"The biopsy came back negative. But Dr. Walton Shim, who's handling Alyshia's case, had told us that if it was positive, they would not be able to save her life and that we would have to make a decision."
Shim said he believes they've stopped the spread of the infection.
Shimizu is encouraged by his daughter's fighting spirit. "The survival rate may not be good but she's holding on," he said. "All of this has made me realize that tomorrow really doesn't belong to you and me."
Alyshia was scheduled to be transferred today by private jet to the Shriner's Hospital in Sacramento, Calif. Annette Shimizu will accompany her daughter.
"The Shriner's Hospital in Sacramento specializes in pediatric burns," Anthony Shimizu said. "They have to treat this like a critical burn because of the tissue loss.
"Right now there's a great risk of infection."
What is it? Necrotizing fasciitis (pronounced neck-row-tize-ing fash-e-i-tis) means decaying skin and is commonly known as the "flesh-eating bacteria."
How do you get it? Streptococci, peptostreptococcic or bacteroides species bacteria enters the body through an opening in the skin that can be as small as a paper cut or pin prick. It also can enter through weakened skin such as a bruise, blister or abrasion. It usually is killed easily by antibiotics but in some cases, a stronger variety of strep causes life-threatening cases.
Where does the bacteria come from? It is most commonly transferred by respiratory droplets or direct contact with secretions of someone carrying Strep A, who might not show symptoms or become ill at all. They cough or sneeze, another person picks up the bacteria on their hands or directly at the point of a wound and the infection occurs.
Can it be prevented? No, but you can lessen your chances with basic hygienic practices, such as using anti-bacteria soap, washing hands frequently and caring properly for the smallest cuts with antibiotic ointments and sterile covering.
How common is it? National estimates are 500 to 1,500 cases a year, of which 20 percent die.
How is it treated? Antibiotic IV therapy and aggressive removal of affected tissue.
What's the likely outcome? Survivors most often require some removal of skin and later skin grafting. In some cases, amputation is needed.
What are the early symptoms? Pain, not necessarily at the site of the injury but in the same region or limb of the body. Also flu-like symptoms such as diarrhea, nausea, fever, dizziness, and intense thirst. The limb, or area of the body experiencing pain, begins to swell and may show a purplish rash.
Critical symptoms? Blood pressure will drop severely and the body begins to go into toxic shock.
When should medical attention be sought? As early as possible and insist at once that necrotizing fasciitis be ruled out since the vast majority of cases are misdiagnosed. That's because the beginning symptoms look like so many other things.
More information available on the Web site at http://www.nnff.org Source: National Necrotizing Fasciitis Foundation.