Kannur: A fish sting has cost a 38-year-old Kannur farmer his right arm and potentially his livelihood. Rajeesh T (38), a native of Madapeedika, Kodiyeri, had to undergo amputation of his right arm due to a severe bacterial infection caused by a catfish bite while cleaning a pond. 

Previously employed at a spinning mill, Rajeesh was forced to switch to farming after the mill shut down during the outbreak of COVID-19. Vegetable farming, along with cattle rearing, became his primary source of income. "I don’t know how to cope with this new reality. My ageing parents are worried about my condition, and I still have to take care of my farm and my cows," he said.

He struggles to sleep at nights. "Even weeks after the surgery it feels like my hand is still there, all scrunched up, even though it's amputated," he said. The phantom limb sensation makes it difficult for him to sleep. A weighty object is placed on his hand for some relief. “I need to go to the doctor every fourth day to get the wound dressed,” he added. Rajeesh now has to learn to do his chores and make a living without his right arm.

It was in February that Rajeesh got stung on his right middle finger while cleaning the pond at his farm. He didn’t think much of it, as he was used to fish bites. The morning after the incident, Rajeesh experienced terrible pain in his hand. “I felt like my hand was on fire. I immediately went to Kodiyeri Primary Care Centre. I was given a tetanus shot and prescribed antibacterial medication. I was asked to wait for 48 hours for the pain to subside,” Rajeesh said.

But before the prescribed time, the pain became unbearable. “My arm started swelling up, and I had pus-filled blisters on the back side of my right palm (dorsum),” Rajeesh said. He then went to Palloor Government Hospital, where the doctors advised him to get admitted at Mahe the next morning so they could drain, clean, and bandage the infected wound. They also gave him an injection for the pain.

After the procedure, the duty doctor who checked his dressing that night advised him to quickly go to a hospital in Kozhikode for specialised care, as the condition of his hand was worsening. “By then, my fingers were blue, and the blood circulation seemed to have been cut off,” Rajeesh said.

Doctors diagnosed the infection as gas gangrene, a rare and potentially fatal bacterial infection. “Gas gangrene is a severe skin and soft tissue infection that causes muscle damage, also known as myonecrosis. It typically occurs in people who are immunocompromised, have long-standing diabetes, or have decreased blood supply (vascularity) to the affected area,” said Dr Anoop A S, director of critical care at Aster MIMS.

“Clostridium bacteria is the primary cause of gas gangrene. When present on surfaces (like your palm), these bacteria are not harmful. However, if they invade tissue through a wound, they can become life-threatening,” said Dr Krishnakumar, a plastic surgeon at Baby Memorial Hospital where Rajeesh was treated. These bacteria thrive in low-oxygen environments and produce toxins that can rapidly destroy tissue. 

“While there is no direct association, if a fish bone injury is contaminated with dirty water, these organisms can enter the wound and later develop symptoms,” explained Dr Anoop.

Initially, the doctors amputated two of Rajeesh’s fingers, but as the infection spread, they had to amputate all five fingers to prevent the bacteria from reaching his heart or brain. “The doctors first told me that two of my fingers would need to be amputated. But three days later, when the infection had spread, they had to amputate the remaining fingers as well,” Rajeesh said.

Rajeesh did collective farming in collaboration with five people on his farmland. He also made a living by selling milk and manure. He had a busy schedule until February. These days he is confined to his room; coming to terms with his loss and learning to move on.