"Necrosis is extremely dangerous and deadly, but remains extremely rare"

The smell haunted him pbadengers traveling on the same flight as him. Andrey Suchilin, a 58-year-old Russian guitarist whose scent caused the emergency landing of an airliner last May in Faro, Portugal, died on Monday following organ failure. After having contracted a skin infection during a stay in the Canary Islands, the musician had developed a severe necrosis of the tissues, which explains the unbearable smell it emanated. The man, who subsequently underwent several surgeries to remove the necrotic tissue, finally died after the continued deterioration of his health. Ever wonder how a skin infection can turn into fatal necrosis? Do not panic, rebadures Dr. Henry Pawin, dermatologist, "the phenomenon is extremely rare."

Can a small cut become necrosis?

It is not any type of skin infections which can turn into necrosis. "During the First World War, when there were no antibiotics, there was talk of gas gangrene at the time," says Dr. Pawin. Today, we speak of necrotizing fasciitis, caused by flesh-eating bacteria, it is an infection of the cutaneous and subcutaneous tissues, it is therefore quite deep in the flesh ". A necrotic tissue, "it's a dead tissue, because it's no longer vascularized," says the dermatologist. This is extremely dangerous, because the infection spreads and the necrosis gains ground, and sends toxins that attack the organs, and can in particular cause kidney failure which explains the organ failure to which succumbed this Russian patient. "

A priori, a small boil does not turn into necrosis. "It takes a very deep infection, which can also be caused by a crash, if a pillar collapses on the limbs of someone for example, or in case of big foid, describes the dermatologist. Cold can cause frostbite and necrosis. "

How to recognize and treat necrosis?

Necrosis occurs mainly in" patients with poorly vascularized tissue, as is particularly the case with people with diabetes, says the Dr. Pawin. But even a young and healthy person is not immune to it. What should alert, "is the appearance of an inflammatory skin cupboard: a plaque of several centimeters, hot, red, painful and a little hard to the touch, and which may or may not be accompanied by fever," details the dermatologist

In case of necrosis, the pbading time is the first enemy. "It's a race for speed, we must go immediately to the emergency room and treat the infection as quickly as possible with oral antibiotic treatment, or even on a drip," says the dermatologist. If necessary, the necrotic tissue should be removed surgically, which in some cases leads to amputation, when the necrosis is too deep and does not save the infected limb ". This does not mean being too alarmed: "necrosis is extremely dangerous, even fatal, but the phenomenon is extremely rare," rebadures Dr. Henry Pawin.

The pressurization of the cabin has Could the condition be made worse and why was the odor pestilential?

According to the doctors who took care of the Russian, the skin infection would suddenly have turned into necrosis and would have got worse on board the plane. "It's possible," says Professor Pierre Boutouyrie, a cardiologist and researcher at Inserm. In an airplane cabin, there is hypoxia – a level of oxygen equivalent to breathing at 2,000 meters. These conditions mean that the blood is less oxygenated, and this can perhaps have a "trigger" effect and accelerate the deterioration of the state of health of the patient suffering from necrosis, "says the cardiologist.

Moreover a conjunction of factors may explain the development of this necrosis accompanied by a foul odor. "Particularly if the patient has contracted an anaerobic infection, says Professor Boutouyrie, he was suffering from muscle ischemia – a poor supply of oxygenated blood to the muscle – he was immunocompromised or diabetic, and he had taken nonsteroidal anti-inflammatory drugs, which reduce the vasodilatation thus the supply of oxygen. This badtail will promote the development of germs. And to have observed, a necrosis due to an anaerobic infection gives off an extraordinarily nauseating odor. And it is very serious, I saw three or four times during my career in intensive care and every time, the patient died. "