Staph and strep led
to death on Maui

The county medical examiner
rules out flesh-eating germs

WAILUKU >> Maui County Medical Examiner Anthony Manoukian said well-known Maui hula instructor Debbie Kamalii's death was not caused by a flesh-eating infection or an antibiotic-resistant strain.

She died of a combination of a staphyloccocus and streptococcus infection that caused a growth of bacteria in her blood stream and a "profound drop in her blood pressure," he said.

"It was just a thigh wound with abscess formation," Manoukian said.

"Anybody's at risk if they have a wound that isn't cared for ... It just depends on the type of bacteria and the wound," he said.

He said the wound was growing streptococcus pyogenes and staphylococcus aureus -- two common bacterial strains that can be found on the skin.

Kamalii's family requested an investigation into her death, partially in light of the relatively short time it took for her to die after a seemingly minor wound.

Kamalii, 47, of Pukalani complained about an infection on her thigh on May 20, went into Maui Memorial Medical Center about 10 a.m. on May 23 and died that same day about 8:30 p.m., her son Adrian Kamalii said.

State Health Administrator Dr. Lorrin Pang said Monday that Kamalii appeared to have a flesh-eating infection but he was awaiting laboratory tests to confirm the findings.

State Health Director Dr. Chiyome Leinaala Fukino yesterday said patient data and laboratory results currently available indicate there is no clear evidence of "flesh eating" necrotizing fasciitis occurring.

Pang also said several patients that had necrotizing fasciitis had also taken nonsteroidal, anti-inflammatory drugs.

Fukino said there are no current public health recommendations regarding avoiding the use of nonsteroidal, anti-inflammatory drugs in relation to necrotizing fasciitis.

Fukino said she doesn't have statistics indicating how often deaths occur from staphyloccocus and streptococcus infections, because the cause of deaths could be a combination of factors.

Fukino said it's difficult to know how long Kamalii had the infection before she complained about the scratch.

But she said once bacteria gets into the bloodstream, the results can be catastrophic.

Fukino said it never hurts to go early to the hospital to get an opinion.

"We really want to say to all of the people of Hawaii it's really important that we take good care of ourselves," she said.