Boils, MRSA Infections Concern Mississippi Health Officials

Jun. 19--PASCAGOULA -- The number of boils -- deep skin abscesses -- being brought to the Singing River Hospital emergency room has increased to the point that nurses are commenting because so many require lancing.

Besides an increase in number, the boils are nastier, bigger and more difficult to deal with, said health professionals.

At Singing River alone, the county's largest hospital, there were 690 cases of boils at the ER in the past eight months, from the beginning of October to the end of May. That's up 215 cases from the number the ER treated during those same eight months before Katrina.

Several factors contribute to the high numbers. One is a new, more aggressive staph that's plaguing not just Jackson County, but also the Coast and the nation. And there's the post-Katrina environment where people are more likely to scrape or cut themselves and let in bacteria.

But boils are also caused by strep and other factors.

Whatever the cause, Kim Gutherz, assistant manager of nursing for the ER, said, "We have never seen so many. We've always had our fair share of them, with the shipyard and outdoor workers, but we've never seen them in numbers as we have now."

And where the ER used to prescribe antibiotics, many of these boils have to be lanced to relieve the pressure and then drained, sometimes with a drain inserted.

"They have a bad odor," Gutherz said, "a horrible odor. Lots and lots of foul-smelling drainage to them, and they seem to be larger."

Charles Howard, director of Singing River Emergency Services who ran the figures, pointed out that the 690 cases of boils in the last eight months represent only 2 percent of the cases that his emergency room treated during that time. Two years ago, boils were 1.3 percent of the caseload.

"Still, it's enough of an increase that we're noticing it," Howard said.

And it's not just the emergency room that's seeing it; primary care doctors and pharmacists are, too.

Bernadette Cuevas with Burnham's Pharmacy in Moss Point said that in her nine years as a pharmacist in Jackson County it was rare to have a customer come in with a boil, and now she sees one a week.

Searcy Kay, a Moss Point mother whose 3-year-old son had one on the back of his leg, said it took 15, 4-inch square gauze pads to absorb all the fluid that came out of his leg when it was lanced at their pediatrician's office.

"I was crying. My husband was crying," she said. "He was crying before it was over."

The boil started with what looked like a spider bite, a pimple that couldn't be popped. It developed a core over several weeks, then became so painful that her son, Miller, complained when he walked.

Healing after the lancing still required extensive antibiotics and warm compresses or soaking four times a day. And even weeks later, a three-inch area around the wound looks bruised, Kay said.

Dr. Okechukwu Ekenna, infectious disease specialist for Singing River, said there are aspects that are peculiar to these infections. For one thing, the new strain of drug-resistant staph is more aggressive, making it more easily acquired.

Some say it's genetically different from the drug-resistant staph doctors used to see in people who had been through long hospital stays.

"Staph can do terrible things, but the sheer numbers and the variety and the way this is presented is different," he said. "I've seen people with up to 100 lesions on their bodies" in Jackson County.

The boils can appear on an ear, elbow, arm or back, but most often are on the leg.

But even many of these will heal on their own if they are drained and cleaned and cared for properly. But it takes extra care to prevent spreading.

Staph is complicated and can cause confusion, even among medical professionals, he said. And he pointed out that this staph, called MRSA, is a problem that's national and beyond.