An Iguana’s Taste For Cakes Leaves A Young Girl With A Mysterious Illness
The bump on a California girl’s hand was mysterious – and growing. It wasn’t until she saw two doctors and had a biopsy that her family realized the cause: the child had bothered a starving iguana with a sweet tooth, resulting in what may be the first documented infection from a bacteria. rare. infection in a human by an iguana bite.
The young girl, Lena Mars, is featured in a scientific presentation on the case to be given at the European Congress of Clinical Microbiology and Infectious Diseases in April. She is still recovering at her family’s home in San Jose, Calif., after the unexpected ordeal, which began while on vacation in March 2022.
Mars and his parents, Julian and Luisa, had taken a trip to Costa Rica. While enjoying one of the many beautiful beaches in the country, the girl’s parents gave her a snack. But it turns out she wasn’t the only one hungry: a wild iguana appeared as the girl ate her cake by the water.
Iguanas are common in Costa Rica. They are harmless herbivores, known primarily for basking in the sun under trees and eating fruits and leaves, but experts say this animal must have developed a sweet tooth.
The iguana ran up to the girl and bit her on the back of her left middle finger, causing her to loosen her grip on the cake. The reptile then ran off with the snack, but left something else behind.
Dr. Jordan Mah, author of the presentation and expert in medical microbiology, worked on the laboratory testing for the case under Stanford University’s Department of Pathology. Mah said the girl’s parents probably didn’t think of the bite when they took her to a doctor because of the bump on her hand.
“I think when they went to seek medical attention for the bump, the bite kind of escaped them because they didn’t see it as a potential exposure, because it had just healed. And it wasn’t until later in the treatment, when it got worse, that it kind of jolted their memory and they brought it to the doctor’s attention,” he said.
Mah says Mars was immediately responsive after the iguana encounter. The wound appeared superficial, but they took the girl to a local clinic, where staff disinfected the wound with alcohol and gave her five days of antibiotics.
The wound appeared to heal in about two weeks. It wasn’t until five months later, when her parents noticed a large bump on the girl’s hand in the same spot, that they thought they should take her to another doctor. The girl told them it didn’t hurt and there were no other symptoms.
Her pediatrician thought the lump might be a harmless cyst and told her parents to keep an eye out for it. But when the bump continued to grow and started causing mild pain, her parents took the girl to an orthopedic surgeon, who suggested a biopsy.
In November, the doctor removed the 2 centimeter lump. Scientists took a closer look at the growth in the lab and discovered that the child had a rare infection with marine mycobacterium a non-tuberculous mycobacterium that more commonly causes tuberculosis-like disease in fish.
It is ubiquitous in fresh and salt water but rarely infects humans. Typically, when humans become infected, it is after a wound has been exposed to bacteria in the water. Most people who get these infections develop a rash that can spread in a spherical pattern. It may develop into a nodule with pus or turn into a an ulcer.
Most antibiotics alone don’t usually work on these types of infections, so doctors started the girl on rifampin, an antimicrobial, and clarithromycin, an antibiotic often used for skin infections. The infection responded well to treatment.
“Usually with these infections, because they take a very long time to develop and they’re a bit more difficult, you have to treat them for a longer period of time, sometimes several months,” Mah said. “So she’s better. I wouldn’t say 100%, but she’s doing much better than she started.
Mah believes this is the first time a human has contracted this type of infection from an iguana bite. He wanted to present the case to alert clinicians to the possibility.
Growing M. marinum in the lab required a lower temperature than most bacteria. This particular bacterium likes to grow at around 82 to 86 degrees Fahrenheit. Most bacteria are grown around 95 to 98.6 degrees, therefore the diagnoses were slightly different. Since lizards and iguanas have lower body temperatures than humans, Mah said, they could be the perfect hosts for this type of bacteria.
“We know a lot about animal bites and bacteria, infections, tracking, say, dogs or cats, but there really isn’t much for lizards, let alone iguanas,” did he declare. “I don’t think people should be afraid, but doctors should be aware of this possibility.”
Iguanas native to South and Central America and Mexico have become an invasive species in South Florida, Hawaii, Texas, and Puerto Rico, so people can have more encounters with them. But experts who work with iguanas say they’re generally pretty harmless, so there’s no reason to be afraid of them.
Anna Meyer, Operations Manager at Iguanaland, Florida’s largest reptile zoo said the behavior of the one in this case is not typical.
“As a rule, they go through their day without wanting to disturb anyone or be disturbed by anyone. But like all wildlife, if they start associating people with food, they’re likely to bond,” Meyer said. In this case, other tourists in Costa Rica might have fed the wild iguana until it got used to people and developed certain expectations of them.
“He’s an animal that just got used to people feeding him food,” Meyer said. He probably realized he could get a “higher value food” from the toddler without too much danger to himself.
The lesson here, she said, is that no one should feed wildlife, because it makes the animal think that stealing food from a child is, well, like taking candy from a Babe.
“There are more calories in a cake than in a mango or leaves,” she said.
The Mars family said their daughter is still recovering from her injury and praised her for the spirit with which she handled the whole experience.
“Our daughter, Lena, has just celebrated her 4th birthday and is still recovering from surgery in November. The wound is healing and the whole healing process has taken on more force than the bite itself,” the family said in a statement, “Lena is the bravest child we could imagine and she handles the situation quite well. She remembers the bite vividly and knows the bacteria came from the iguana. She doesn’t will probably never forget the experience, but hopefully one day we can all laugh at what happened.
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