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Hilary Swank Kicks Staph Infection

Antibiotics Work Well, but See Doctor When Swelling, Redness Develops
By
WebMD Health News

Jan. 28, 2005 -- Actress Hilary Swank has disclosed that she developed a serious staph infection while shooting the movie Million Dollar Baby. Her infection is known medically as staphylococcus cellulitis.

In Swank's case, it started with a blister on her foot, resulting in "red marks going up my leg," and was extremely painful, she told Mike Wallace on CBS's 60 Minutes.

WebMD consulted Luis Ostrosky-Zeichner, MD, an infectious disease specialist at The University of Texas Medical School at Houston, for details on this type of staph infection.

What is staph infection?

It is a type of infection caused by a Staphylococcus (or "staph") bacteria. Actually, about 25% of people normally carry staph in the nose, mouth, genitals, and anal area. The foot is very prone to pick up bacteria from the floor. The infection often begins with a little cut, which gets infected with bacteria.

These staph infections range from a simple boil to antibiotic-resistant infections to flesh-eating infections. The difference between all these is how deep and how fast the infection spreads, and how treatable it is with antibiotics. The antibiotic-resistant infections are more common in North America, because of our overuse of antibiotics.

The type of staph infection that Swank had -- cellulitis -- involves the skin's deeper layers. It was not the flesh-eating type of infection. And it was treatable with antibiotics.

This type of infection is very common in the general population -- and more common and more severe in people with weak immune systems. People who have diabetes or weakened immunity are particularly prone to developing cellulitis.

What does staph infection look like?

Staph cellulitis usually begins as a small area of tenderness, swelling, and redness. Sometimes it begins with an open sore. Other times, there is no break in the skin at all -- and it's anyone's guess where the bacteria came from.

The signs of cellulitis are those of any inflammation -- redness, warmth, swelling, and pain. Any skin sore or ulcer that has these signs may be developing cellulitis. If the staph infection spreads, the person may develop a fever, sometimes with chills and sweats, as well as swelling in the area.

What can be done about a staph infection?

Antibiotics are used to treat these infections. But there's been a gradual change in how well these antibiotics are working. While most staph infections used to be treatable with penicillin, in the 1980s that changed and stronger antibiotics are now used.

In about 50% of cases, however, we see resistance to even these stronger antibiotics. These cases are not just happening in hospitals -- as once was true -- but now are occurring in the general community. That's been a problem. Many doctors are accustomed to using certain antibiotics, but those then fail because of antibiotic resistance. There are several more potent antibiotics now, but doctors need to know when to use them.

There's another treatment we sometimes use with staph infections. If the infection goes so deep that it involves muscles or fibers that enclose muscles, it needs to be surgically cleaned.

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