One of the odder aspects of infection is that microbes that normally do no harm at all sometimes get into the wrong parts of the body and "go kind of crazy," in the words of Dr. Bryan Marsh, an infectious diseases specialist at Dartmouth-Hitchcock Medical Center in Lebanon, New Hamphire. "It happens all the time with car accidents when people suffer internal injuries. Microbes that are normally benign in the gut get into other parts of the body—the bloodstream, for instance—and cause terrible havoc."
The scariest, most out-of-control bacterial disorder of the moment is a disease called necrotizing fasciitis in which bacteria essentially eat the victim from the inside out, devouring internal tissue and leaving behind a pulpy, noxious residue. Patients often come in with comparatively mild complaints—a skin rash and fever typically—but then dramatically deteriorate. When they are opened up it is often found that they are simply being consumed. The only treatment is what is known as "radical excisional surgery"—cutting out every bit of infected area. Seventy percent of victims die; many of the rest are left terribly disfigured. The source of the infection is a mundane family of bacteria called Group A Streptococcus, which normally do no more than cause strep throat. Very occasionally, for reasons unknown, some of these bacteria get through the lining of the throat and into the body proper, where they wreak the most devastating havoc. They are completely resistant to antibiotics. About a thousand cases a year occur in the United States, and no one can say that it won't get worse.