Cellulitis & Necrotising faciitis (fashee-Eye-tis).

 This would be quite a long narration.  The information it shares may benefit arguably  a few alone. If you are disinterested please do not go any further. 

I am not a doctor. I could never have been one, the way I had been, the build I had had.

Recently, I came across 'Complications' by Atul Gawande, Surgeon at USofA. He is a prolific writer on medical science and it's challenges and has published a large number of books drawing deep from his experience and vast array of knowledge.

I am awestruck by his lucid description of two ailments that may afflict human beings.

One is Cellulitis and the other is Necrotising faciitis (fashee-Eye-tis).

While Cellulitis is a simple skin infection, Necrotising Faciitis  is described as a horrendously lethal type of infection. The tabloids call it, a flesh eating bacteria because the infection kills 70% of the people who are affected.

Cellulitis is the garden variety skin infection, the result of perfectly ordinary bacteria in the environment getting past the barrier of skin through a cut, a puncture wound, a blister or whatever and proliferating within it. The skin becomes red, hot, swollen and painful. You feel sick. Fevers are common. The infection spreads along the skin. Antibiotics and a tetanus shot subdue Cellulitis.

I came to know of Cellulitis very recently when I once phoned Raju, a routine. He said they were in the Mandiram Hospital. Leela had swelling on her feet that did not subside. Fortunately Mandiram had a Vellore trained doctor who could identity  the symptom and the treatment was effective, Raju said.

Unnikunju, Ann's Appa, (Ann is Ashwin's (our younger son) wife) had visited us. The true farmer he is, an erstwhile Principal, Govt. Higher Secondary School, he ventured into our plot of land - something I shy off- and when he returned there was a slight scratch on his leg. He ignored it and  didn't think much of it. However, on his return to Kadammanitta, the scratch developed into an infection of bigger proportion and the effect wore off only after undergoing treatment for a couple of months. He is not diabetic.

Last Monday, 20thMarch, we were in Thalavady. I visited Appu Sir who stays close by. We knew each other from Valiappachan's time. He said he is 95. His daughter told me he was 97. He looked fit, but needed the support of a walking stick. He said the paraphernalia was the consequence of an attack of Cellulitis. Initially, he said, the leg had swollen like that of an elephantiasis patient. He was in great misery. 

He was operated upon by  a Surgeon at Alapuzha. 

The attending Sister told him the lady on the adjacent bed too had similar ailment and her life could be saved by subjecting her  through  amputation.

Necrotising faciitis is highly aggressive and rapidly invasive. No known antibiotic will stop it. One in a population of 250000 is afflicted by it. As with Cellulitis it enters the body through breaks in the skin. The break can be as large as a surgical incision or as slight as an abrasion.

 People have been documented to have gotten the disease from a rug burn, a bug bite, a friendly punch in the arm, a paper cut, a blood draw, a toothpick injury and chicken pox lesions. In many the entry point is never found. 

Unlike Cellulitis, the bacteria invade not only the skin but also deep underneath the skin consuming whatever soft tissue it finds. 

Survival is possible only with radical excisional surgery that often requires amputation.

(All the scientific materials are quoted from

'Complications' by Atul Gawande)