Citing privacy, health officials declined to provide details on the fatality or the two other patients, except to say they are no longer hospitalized.
Officials were alerted Monday when the University of Maryland’s infection-control unit notified them that three patients who had procedures at the cosmetic surgery center between mid-August and mid-September had contracted invasive streptococcal infections and that one had died.
The women had Group A Streptococcus infections. The bacterium is often found in the throat and on the skin, and people who carry it may have no symptoms of illness. Most GAS infections are relatively mild illnesses, such as strep throat. But occasionally these bacteria can cause severe and even life-threatening diseases when they infect parts of the body where bacteria usually are not found, such as blood, muscle or the lungs. These infections are known as “invasive GAS disease.” About 10 to 15 percent of patients with the disease die from the infection.
One of the most severe, but least common, forms of the disease is necrotizing fasciitis, sometimes described as “the flesh-eating bacteria.” Health officials declined to give specifics about the patients’ infections.
People with skin lesions such as cuts, surgical wounds and chickenpox, or the elderly and adults with a history of alcohol abuse or injection-drug use have a higher risk for invasive GAS disease.
Officials are urging individuals who had any procedure at Monarch Med Spa and who have concerns about an infection to check with their doctors. Symptoms include fever; redness at the wound site; abrupt onset of generalized or localized severe pain and swelling; and progressive dizziness, weakness and confusion.
A spokeswoman for Monarch Med Spa said the company has voluntarily agreed to suspend all procedures at its Timonium facility as a precautionary measure pending an investigation by the Maryland Department of Health and Mental Hygiene.
In a statement, Monarch said its “primary concern is for the safety and well-being of all of our patients, and we extend our deepest sympathy to deceased patient’s family.”
Monarch, in business for eight years, has “successfully performed thousands of complication-free surgical procedures performed by licensed health professionals,” it said. The company performs nearly 40,000 procedures annually and uses “only highly trained and licensed professionals,” according to its Web site. It describes itself as “the East Coast leader in its field.” One of the monthly specials includes $750 off and 0 percent financing for liposuction procedures, according to the Web site.
The suspected infections, the company said in its statement, “are a new development and their possible origins are being closely and carefully investigated.”
The company has three locations in Pennsylvania — King of Prussia, Philadelphia and Harrisburg — and another in Greenville, Del.
Cosmetic surgery centers in Maryland are not subject to state licensure. The state health department will seek public comment in the near future on potential approaches to oversight of these facilities, health department spokeswoman Dori Henry said.
Peter Pronovost, senior vice president for quality at Johns Hopkins, said the increasing number of centers that perform outpatient procedures, including cosmetic surgery, poses risks to consumers.
“It’s a bit of the Wild West out there,” he said. “There’s no oversight. . . . We have closer inspections of restaurants than we have of health care.”
Over the past five years, an average of 189 cases of invasive GAS were reported annually in Maryland. About 9,000 to 11,500 cases of invasive GAS disease occur each year in the United States, resulting in 1,000 to 1,800 deaths, according to federal statistics.