An invisible adversary: An unseen wound can become gateway for staph infection to enter the body
by Joe Medley
Sports Columnist
Oct 26, 2009 | 8130 views |  2 comments | 38 38 recommendations | email to a friend | print
Since 2000, awareness of staph infections in sports has grown. A 2007 survey of high school athletic trainers found that 53 percent of them had treated staph infections in football players. Photo: Bill Wilson/The Anniston Star
Since 2000, awareness of staph infections in sports has grown. A 2007 survey of high school athletic trainers found that 53 percent of them had treated staph infections in football players. Photo: Bill Wilson/The Anniston Star
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Part 2 of 3 This is the second in a three-part series about staph infections and local sports programs. Today's story centers on cases involving two Jacksonville Christian Academy football players and one Anniston High coach to demonstrate how easily infections occur, spread and defy diagnosis.

Eddie Bullock would do nearly anything for his alma mater, which is why he coaches three Anniston High sports and assumes tasks like washing football uniforms.

He learned the hard way that his loving labors can cause a painful case of MRSA, the most dangerous form of staph infection.

“The doctor asked what kind of work that I do,” he said. “I said I coach. I do all the cleaning, washing clothes for the football team. He said that’s where I got it.

“He said all it takes is just to be in your nose hairs or if you rub it, a bruise inside or if you scratch your nose.”

Bullock’s case, plus known cases at Pleasant Valley High and Jacksonville Christian Academy, give local testimony to the growing problem of staph infections in sports.

What has long been a concern in hospitals and nursing homes has become a concern in locker rooms and training rooms in high school, college and even professional sports.

Awareness of staph infections in sports began to surge around 2000 and has grown, especially in football. A 2007 Centers for Disease Control and Prevention survey of high school athletic trainers revealed that 53 percent had treated MRSA infections in football players.

MRSA, or methicillin-resistant Staphylococcus aureus, is the most drug-resistant form of staph and can be fatal. An MRSA infection left Pleasant Valley senior David Pitts paralyzed below the sternum.

JCA’s David Parris has battled MRSA’s ranging effects for a year, and it sidelined him for his junior football season with the Thunder. Ward Reid, one of Parris’ teammates, spent three weeks recovering from a lesser staph infection. He returned to school a week ago.

Many more common staph infections are not so severe. Athletes get the infected areas sufficiently wrapped and play their sports.

But athletes, especially those in contact sports like football, play and dress in environments that can breed these sneaky infections.

Some, like Pitts (whose story was told in Sunday’s Star), acquire the infection without an apparent open wound.

A possible explanation for such cases is that some skin wounds are too small for the naked eye to detect, according to Anniston physician Raul Magadia, who specializes in infectious diseases.

“You’re dealing with a staph infection, which is about 0.6 microns in diameter,” said Magadia, who has lectured on staph at Anniston and Oxford high schools. For comparison, human hair ranges in width from 40 to 120 microns. “It’s very tiny, so you really can’t see it.

“It doesn’t take a whole lot for the bug to get into a skin cut that otherwise is not seen by the human eye.”

If the patient becomes bacteremic, meaning bacteria enters the blood stream, staph can travel to vital areas in the body. Pitts and Parris developed abscesses on their spines.

“Staph infections are very opportunistic,” Magadia said. “They will go to a place that has the least resistance.

“If you become bacteremic — and let’s say you have a weak spine to begin with from an injury that’s not really that bad, but that area is somehow relatively weak compared to the rest of your body — once you have a blood infection, it will go there.”

Some people are staph carriers, and the infection lives on their skin. It can transfer to clothing or protective pads, and athletes can infect each other through contact or from sharing towels.

Oxford football coach John Grass said a staph outbreak while he coached at Moody High School was traced to a batch of unwashed wristbands.

In football, studies show that linemen and linebackers are most likely to get staph because they have more close contact.

Once staph infections occur, diagnosing them can be tricky. Magadia said doctors should ask questions.

“Are you having any fever? Is it really painful?” he said. “They’ll ask history and things like that. Have you been in contact with someone who might be sick or might have something else? What kind of sports do you do?”

Still, an MRSA diagnosis can come late in the infection’s progression. In Pitts’ case, an MRI taken nearly a month after he fell and hurt his right elbow in basketball practice revealed the abscess. Other staph stories among area coaches and athletes show just how easily an infection can occur and elude detection.

Just doing the wash

Bullock had no idea he had MRSA in late spring of 2008.

Soon after the conclusion of Anniston’s spring practice, he washed the Bulldogs’ uniforms one last time before storing them for the weeks between spring and fall practice.

He started to notice tenderness on the tip of his nose.

“It was real sore,” he said. “I didn’t pay attention to it. I don’t get sick that often. When something lingers, I’ll get it checked.

“I went to the doctor, and he gave me some antibiotics for it. I thought it was sinuses acting up.”

The tenderness went away for nearly two months but returned, so bad that “it was killing me,” he said. He wished it away for a day. Then came Sunday, and Bullock was struggling through his duties as piano player in his church.

“I was so miserable in church,” he said. “I couldn’t keep my head up. I was about to go out on that piano.

“After church, I told my wife, ‘I’ve got to go to the doctor.’”

The doctor asked the right questions and swabbed Bullock’s nose, which had gotten “about hard as a piece of concrete,” Bullock said. “You could tap the tip of my nose with a pin. It was that hard.”

Four days later, the doctor called with an MRSA diagnosis and recommended quick and aggressive treatment, which included four shots plus two prescriptions. Bullock took one prescription for 10 days and the other for a month.

As painful as Bullock’s ordeal was, he said he’s fortunate.

“I was scared, when he (the doctor) first told me about it,” he said. “I didn’t know you could die from it, especially if you don’t get it treated.”

Delayed onset

Like Bullock, Parris didn’t suspect MRSA when he broke his left hip in a game against St. Bernard Prep in October 2008. He just knew his hip wasn’t his only problem.

“It got better, but my back never got better,” he said. “It would get better, and then it would start hurting again.”

He didn’t think much of it and went about offseason workouts and spring training with the on-and-off back pain. He had two good practices leading up to JCA’s spring game and played in the game.

“By that next Saturday, I could hardly move around, and it just kind of got worse,” he said.

Parris saw a doctor, then started therapy for his back. It worked for a time, but his pain returned in late July.

He saw a different doctor, and an X-ray revealed what looked to be an infection in the area of the L2 and L3 vertebra.

Parris was referred to a neurosurgeon, who performed an MRI. The next day, Parris underwent a biopsy, and the culture from the abscess on his back was diagnosed as MRSA. He began an eight-week regimen of antibiotics, which he completed about a month ago. He’s getting back to normal and expects to resume playing sports in January.

A question surrounding Parris’ case was how he contracted MRSA from the hip injury, which had no open wound. Tracing his steps, he recalled a knee wound from earlier in the 2008 season.

One of his coaches treated the infection that developed on his knee, but no one foresaw what doctors say likely happened after that.

“I didn’t think anything of it until they told me I had staph,” Parris said. “They asked if I had any places that got infected prior to my (hip) injury in October, and I said I had this one place on my knee.

“They said that’s probably where it started. When I got hurt, it harbored around my spine. When I put stress on it, it released and started eating my disc and stuff.”

Not MRSA, but scary

Ward Reid’s father said doctors don’t know for sure how his son developed methicillin-sensitive Staphylococcus aureus, or the lesser staph infection more commonly called MSSA. Perhaps the culprit was the cut Ward Reid had on one of his elbows about two weeks prior to JCA’s victory over Skyline on Sept. 25.

Whatever the cause, the certainty is that the junior lineman suffered a hip injury in the Skyline game, touching off an infection that left him hospitalized for nine days.

His symptoms started with fever on the Saturday night following the Skyline game.

“We just thought it was the flu,” Frank Reid said. “There’s been so much going around, so we were just waiting it out.

“Finally, Sunday night, it just got to the point where we had to take him to the emergency room. His fever was staying so high.”

Ward Reid was not admitted that night “because they said they couldn’t find anything wrong with him,” Frank Reid said.

But fever persisted, and the Reids returned to the hospital two days later. Doctors admitted Ward Reid upon discovering effects on his liver and spleen.

“And we started noticing that he was turning yellow,” Frank Reid said.

It took until Friday, a week following the hip injury in the Skyline game, for the culture to grow and reveal that Ward Reid had MSSA.

“They kept telling us a different diagnosis, but every time the test would come back negative on all the other things they were saying it was,” Frank Reid said. “It was almost like staph was the very last thing they were looking for.”

Doctors told the Reids that MSSA “was the good one to have, if you were going to have it,” Frank Reid said. “But it sure was rough on him.”
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