MERIDIAN — OCEAN SPRINGS -- Joseph Smith, 44, bumped his leg last week and noticed a bruise that worried him and his fiancée, Renee Collins. So he went to the emergency room.
Doctors looked at it and sent him home, but pressure was building in the leg, he said. "I thought it was a bruise, but my skin just turned blue and black." So he went back to the emergency room.
By the end of the week, blood work confirmed he had an infection of vibrio bacteria -- also known as a flesh-eating bacteria -- and he needed surgery. Smith and Collins, both of Ocean Springs, talked with the Sun Herald from his room at Ocean Springs Hospital.
"He bumped his leg on Monday," Collins
said. "Tuesday he was in the emergency room and on Saturday, they were removing his leg to save his life."
It has been a shock and a life-changing event, Smith said.
He pointed out the portion of his right thigh above the knee that remains and said, "It was already up past here."
As he sat in his hospital bed Thursday, recounting the events, Smith said he was told it was a race with time to save his life.
At one point, the doctors talked of using a hyperbaric chamber to help fight the infection, or perhaps skinning his leg to remove the bacteria, Collins and Smith said. But in the end, doctors told them amputation was the only way to beat it.
"I said, 'Let me talk with my girl,'" Smith said, nodding to his fiancée.
She said, "It was a hard decision, but he's here. We can still have a wedding. We can get through this. We'll get through this."
The wedding is still on for the end of October, she said.
"I just want to make sure I'm fixed," Smith said. He had a second surgery Tuesday to close the amputation wound, they said. It has been draining. He is on heavy antibiotics and has had a number of blood transfusions.
"It was unbelievable," he said. "Like a blink of an eye."
Smith believes he got it from being exposed to bait while fishing recently off a pier on the Coast.
Vibrio thrives in the Gulf of Mexico's warm waters and can cause infections with results similar to Smith's, according to the Centers for Disease Control and Prevention.
Joe Jewell, with the state Department of Marine Resources, said Smith's is the first report he's heard this year in Mississippi, but there have been cases in the past.
The DMR tracks vibrio vulnificus -- one of the worst types of vibrio -- back to the source when it is found in raw seafood and oysters, Jewell said, "but when it's wound-related infection, we do not."
The bacteria, living in the water, can enter through a puncture wound or crack in the skin, Jewell said. It attacks people whose immune systems are compromised -- usually by diabetes, cancer treatments or liver illness. It can also infect a person through infected seafood.
"But there is very little you can do about it," Jewell said. "It's in the water all the time. It affects the at-risk population. All you can do is educate that population."
Dr. Robert Travnicek, with the state Health Department, said the frail elderly can be included in the at-risk group, but out of "thousands and thousands of cuts, you possibly get one infection.
"It's a terrible disease, but usually in people who are sick in other ways," Travnicek said. He said Coast emergency rooms are good at detecting it, "but we've had some deaths."
Since time is of the essence, misdiagnosis can be deadly.
Jewell said the survival odds for someone with a compromised immune system are less than 50-50.
Smith said he believes a skin disorder he contracted in recent years, which caused a rash and cracked skin, allowed the bacteria into his system. He said he has taken regular doses of steroids to combat the skin disorder and fears that might have compromised his immune system.
Dr. Okechukwu Ekenna, an infectious disease specialist in Pascagoula, who is treating Smith, said there is more than one type of vibrio. He spoke to the Sun Herald with Smith's consent.
Ekenna said the tests are still out on what type Smith has. Some are worse than others. The bruise Smith had on his leg may also have played a part, Ekenna said.
Change of plans
Smith is a carpenter and has worked security. But always with two legs.
"I'm a pretty durable guy," he said. "Now, I'm going to be disabled."
But he was grateful to be alive and wanted others to know about the vibrio bacteria in the water. Collins is retired from the Air Force and looked up the bacteria when they received his diagnosis.
"I'm pretty well educated and I didn't know about it," she said.
Smith had planned to take classes in air conditioning repair this fall, but that might have to wait, he said.
Then he paused and rethought the issue.
"I don't know," he said. "I guess I could take classes in a wheelchair."