ambulance to the better-equipped
Sanford USD Medical Center in nearby
Sioux Falls.
An ultrasound of Sharon’s arm
showed that she had a deep-vein
thrombosis, a type of blood clot. Usu-
ally it strikes in the lower legs, not the
arm. There was also a great deal of
swollen soft tissue, presumably from
the cellulitis. Sharon was still in agony.
Her doctors questioned her about
any recent injuries or illnesses. “We
tried to dig deeper,” says Dr. Dima
Nimri, an internal-medicine resident
on the team that treated Sharon. “But
there was nothing that could explain
the onset of right arm pain and swelling
over the course of a week.” After two
days of treatment with a broad anti-
biotic, Sharon still wasn’t improving.
Her doctors increasingly suspected
necrotizing fasciitis, the notorious
flesh-eating bacteria—especially when
it became apparent just how rapidly
the infection was spreading. Two
mornings after Sharon arrived, a team
from orthopaedic surgery drew a bor-
der around the red area to track its
progress. By afternoon, the redness
had already expanded beyond the out-
line. Meanwhile, they could see on an
MRI that the infection had invaded the
deeper muscles.
Sharon’s arm had to be operated on,
and quickly, before the infection could
spread out of control and threaten her
life. Dead tissue was removed, and the
infection cleaned out. Two days later,
the surgeons went in again. A bacterial
culture was done, and Sharon was
switched to more effective antibiotics.
It was upsetting for Sharon, Nimri
recalls. “Before she came here, she
didn’t think the infection was that seri-
ous. But the sequence of events devel-
oped really fast.”
Now the arm was finally healing, but
the doctors still needed to find out
what had caused a seemingly healthy
woman to get a blood clot and severe
infection in the first place.Her blood tests showed obvious
problems. She was high in inflamma-
tory markers and, more concerning,
her number of white blood cells was
dropping drastically. When that hap-
pens to someone, they’re either failing
to produce enough white blood cells,
suggesting a bone marrow disease, or
the body is destroying the cells, which
can happen when the spleen’s func-
tion is compromised.
A bone-marrow biopsy was taken
and ruled out leukemia, but mean-
while, there was an unusual detail the
doctors started pondering. VariousSPECIALISTS WHO
HAD INTERACTED
WITH SHARON NOTED
HER SLIGHTLY
CROOKED HANDS.rd.ca 25