'Nightmare' of woman seeing son fight for life: The killer microbe: A man has survived the life-threatening infection, at a price of appalling trauma. Liz Hunt reports

JOAN ARMSTRONG describes the three weeks in January that her son was fighting for his life against a deadly microbial infection as a 'living nightmare'.

Stephen Smith, 25, had three emergency operations in January to remove the infected tissue from his right hip and buttock area after a streptococcal infection progressed to the gangrene-like illness, necrotising fasciitis.

At one point, surgeons at the Mount Vernon Hospital, Middlesex, thought they would have to amputate his penis. 'Everytime I went to see him, it was as if there was a little bit less of him there,' Ms Armstrong said yesterday. 'They took out a huge grey piece of tissue, the size of a saucer, the first time, leaving a wound about an inch deep so you could see his hip bone.'

The hip bone is still partially visible and he is awaiting extensive plastic surgery to rebuild the buttock and pelvic area. 'It is not cosmetic surgery, it is essential to protect the bones and other organs,' he said last night.

Mr Smith, a plumber and heating engineer from Tooting, south- west London, was knocked over by a car on 12 January. His injuries did not appear serious - some bruising and a graze on his right side. During the night the bruising spread and became more painful. The next day he was coughing and vomiting blood. He went to Edgware Hospital in north London, where he was living at the time, where his pelvis and head were X-rayed. Doctors gave him painkillers, told him he had a possible fractured pelvis and that he should go home and rest.

But Mr Smith's condition worsened. He returned to the hospital and was given cream to put on the bruised area. 'I could not get out of bed and everything swelled up, my penis and everything. My girlfriend called the GP, who called an ambulance and I was taken to Barnet General. They didn't know what it was but pumped me full of antibiotics.'

His skin was now turning yellow, then black and it was spreading at an alarming rate. Mr Smith was transferred to Mount Vernon Hospital where a streptococcal infection and necrotising fasciitis were diagnosed.

Three emergency operations were necessary to remove the gangrenous tissue, and during the second operation he was given only a 50-50 chance of survival. His mother was told that it may be necessary to remove all of the genital area.

Mr Smith had to operated on at the end of each day, the last patient to be taken into the theatre to reduce the risk of spreading the infection. 'They were terrified of other patients developing it. They had to scrub the theatre from top to bottom after me,' Mr Smith said. 'I was never worried about dying but I was terrified of losing my penis.'

He was discharged from hospital after three weeks, still in a great deal of pain. Skin, fat and muscle had been removed from his thighs to pad out the wound area and protect the tissues that remained. However, this is a temporary measure and these 'donor pads' will be taken out before plastic surgery later this summer.

Mr Smith, who has just returned to work, is philosophical about his disfiguring wounds and the prospect of more surgery which lies ahead. 'They are going to expand the skin around the wound with saline bags, and then draw it together to cover the wound and my hip. I'll have scars everywhere but I know now how lucky I am when I hear about all these other cases.'

(Photograph omitted)

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