Peck on the leg from a magpie leads to amputation

A new study has revealed that a peck on the leg from a pet magpie resulted in an elderly Australian woman losing her lower leg.

Apparently the 84-year-old woman from Newcastle in New South Wales (NSW) developed a rare soft-tissue infection caused by the magpie's infectious peck on her ankle. The magpie was her daughter's pet.

It appears that within a week of being pecked she experienced pain, swelling and redness near the injury site and when she was admitted to hospital she was unable to bear weight on the affected leg but there was no fever, and her white cell count was normal.

Dr Paul Wilson and staff at the Calvary Mater Hospital in Newcastle treated her with antibiotics and anti-fungal drugs for a period of 16 days, but over the course of the next two weeks her leg did not improve and despite additional drugs and a change in the drug regime, she developed a fever and her white cell count rose progressively.

A scan of the thigh revealed the infection had spread and the foot became gangrenous and doctors were forced to amputate her leg from above the knee on day 17.

Within 6 days of the surgery the infection was cleared and after 44 days in hospital the woman was discharged to a nursing home.

Dr Wilson, an infectious-diseases specialist says the case was particularly unusual for a number of reasons - firstly, the mechanism of injury - it is uncommon for people to get infections after being pecked by birds - and secondly, the actual organism is an uncommon one that rarely causes human infections.

The infection was caused by the fungus Saksenaea vasiformis, an uncommon human pathogen which requires special culture techniques to enable it to be identified.

Dr Wilson says it is an uncommon human infection and was first seen in 1977 in a young man who had sustained a severe skull trauma in a motor vehicle accident.

In total there have been only 29 reported cases of human infection arising from the action of this fungus in English-language medical literature.

According to Dr Wilson the infection might have been less severe had the woman not been a former smoker and had not had pre-existing circulation problems - she had a history of heart problems and mild chronic obstructive pulmonary disease, had undergone a hysterectomy and varicose vein ligation and was an ex-smoker.

Dr Wilson says had her circulation been better she might not have needed amputation. But Dr Wilson says infections caused by bird peckings were rare and not a worry for the general public.

According to the research incidents of skin or soft tissue infections following bird pecking injuries are sparse but include an infection of the finger after a swan bite, a scalp infection after an owl attack, septic arthritis of the knee after a chicken bite, a fatal brain abscess in a child caused by a rooster peck and other infections caused by insect or spider bites.

A report of the case by Dr Wilson can be seen in the latest edition of The Medical Journal of Australia.

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