In case you’ve been reading the news about the New York Giants (and as anyone who has read this exciting and thrill packed blog, you know I’m as much of a sports fan as a bookish NYC podiatrist can be), there’s been quite a bit of tension in the Giants locker room lately. And no, this time it has nothing to do with Brady and the possible ball deflating but otherwise pride inducing in my Boston blood Patriots. Word around town is that Daniel Fells has undergone at least 5 surgeries to treat an MRSA infection in the foot or ankle, contracted after a simple cortisone injection. Before you freak out, let’s talk.

MRSA is an acronym for methicillin resistant staphylococcus aureus, which is a resistant form of the most common infecting organism in skin and soft tissue infections, staph aureus, the source of the ubiquitous “staph infection.” Most simple infections involving soft tissue and skin of most parts of the body are attributable to staph, and most strains are readily treatable with many available antibiotics, mostly advanced forms of penicillin, since almost all strains of staph are currently resistant to regular penicillin. And this resistance is not new, it’s been developing since penicillin was first used in the 1940’s. Over time, staph became resistant to even advanced strains of penicillin, the most common of which was methicillin, hence the term methicillin resistant staph aureus. While there are still a few antibiotics active against MRSA, resistance is developing to even the stronger antibiotics, although it is still rare. MRSA at this point is a very common infecting organism, and while it was once confined to hospital settings, is now becoming more common in the community, and the community based infections, like Daniel Fells’ foot infection, often start with a pus filled blister that can eventually progress to a serious and systemic infection. Therapy is directed at eradicating the infection through a combination of medicine and surgery.

There are a few take home points here that are important to keep in mind: These infections are still rare in the community setting, and like almost any other medical condition are more readily treated in the early stages. There is no such thing as a simple procedure, and even a cortisone injection can have dire and unexpected consequences. That said, a limb or life threating infection after a cortisone injection is very unexpected because it is very uncommon. There is no substitute for hygiene, sterile technique, vigilance in detecting and treating infections, and judicious and cautious use of antibiotics to further prevent the development of resistant strains of bacteria.

Daniel Fells we wish you all the best. Hoping that you will have a speedy recovery and this incident will raise awareness that even in 2015 we are still in a Darwinian battle with the most primitive of microscopic creatures.

See you in the office.

Ernest Isaacson

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Ernest L Isaacson DPM PC
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