Rare skin diseases that kill

Matt Nichols holds his two-week-old baby, Ruby Ann, in his Bangor home. Nichols' wife, Heather, 29, passed away on August 8, 2013, at Eastern Maine Medical Center from necrotizing fasciitis, a flesh eating bacteria, that she contracted from an episiotomy during childbirth.BANGOR, Maine — Matt Nichols cradled his newborn daughter, Ruby Ann, in his arms Wednesday morning, gazing into her sleeping face.

When Matt, 29, accompanied his pregnant wife to Eastern Maine Medical Center on Aug. 1, he said he never could have imagined he’d raise their first child on his own after a vicious infection claimed the life of his wife just days after giving birth. Heather Nichols, healthy and also 29 years old, had carried little Ruby through a normal pregnancy. She’d researched the ins and outs of pregnancy and childbirth, preparing herself to become a mother.

Two-week-old Ruby Ann Nichols grasps her father, Matt's, finger.After 20 hours of labor, Heather gave birth with Matt at her side. A framed photo in the couple’s Bangor apartment shows her beaming, holding Ruby in her arms.

But, as Matt explained, things soon took a turn for the worse after the young family returned home. Matt said Heather had undergone an episiotomy, a small surgical incision that enlarges the vaginal opening to assist with childbirth, and the swelling and pain, while expected, worsened overnight.

The next morning, she returned to the hospital expecting a prescription for some medication. But Heather never left.

A photo of Matt and Heather Nichols sits near their daughter Ruby's crib.As Matt, Heather and their loved ones would discover over the following days, Heather had contracted a rare and rapidly spreading bacterial infection called necrotizing fasciitis, he said. Commonly known as “flesh-eating bacteria, ” the infection ravages muscles, fat and skin tissue, typically entering the body through a break in the skin, such as a cut or scrape.

The disease can be caused by several types of bacteria, most commonly group A Streptococcus, otherwise tolerable germs commonly found in the throat and on the skin. Infections from group A strep are usually easily treated, but in some cases produce toxins that can destroy the tissue they infect.

“This one just came completely out of left field, ” Matt said. “Everybody I knew had never even heard of it.”

Matt Nichols adjusts his two-week-old daughter, Ruby's, blanket as she sleeps.While necrotizing fasciitis is rare, its precise prevalence is hard to pin down because the condition itself doesn’t have to be reported to public health officials.

It occurs in fewer than 1 in 100, 000 reported hospital infections, said Dr. James Raczek, chief medical officer at EMMC.

Raczek said he could not confirm whether the hospital recently had recorded a case of necrotizing fasciitis. Asked to comment on Heather’s case, he declined, citing patient confidentiality rules.

In an email Wednesday afternoon, EMMC spokeswoman Jill McDonald wrote: “I can confirm that Heather Nichols is deceased.”

In Maine, hospitals are required to report cases of group A strep that lead to serious illness, including necrotizing fasciitis. Some other bacteria that can result in the condition do not have to be reported, however.

The Maine Center for Disease Control and Prevention has not received any reports recently of group A strep resulting in necrotizing fasciitis, according to Dr. Stephen Sears, state epidemiologist.

Matt Nichols holds his two-week-old baby, Ruby Ann, in his Bangor home. Two-week-old Ruby Ann Nichols.
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