ST. GEORGE — A 14-year-old girl who was playing a game that involved friends scratching letters into the skin got an infection that was potentially fatal.

A scratch on the girl's hand caused necrotizing fasciitis, an infection in which toxins destroy skin and muscle.

Since her left arm became infected in early March, the girl has gone through seven surgeries to remove tissue infected with the flesh-eating bacteria and has had oxygen treatments twice daily.

Doctors, who were initially worried the teen would not survive, said the arm shouldn't have to be amputated but will probably be less functional than before the infection.

"Necrotizing fasciitis has a very high fatality rate that can approach as much as 60 percent," said Nicholas Bird, medical director for hyperbaric medicine at Dixie Regional Medical Center. "If someone doesn't die, they're very likely to lose a limb or a part of a limb."

Edward Fernandez, the girl's stepfather, said she was scratched by a friend while they were playing a game to see how many letters each could scratch into the other's skin.

"I guess the girls were playing a game called the 'ABC game,"' Fernandez said. "The kids go through the alphabet, they keep scratching to see how far you can go."

The girl's mother brought her to the hospital on March 8 with her arm swollen and bruised up to the armpit. The next day, doctors figured out what had caused the infection.

"She wound up with this infection with a small scratch on the skin and that was enough of a break in the skin to allow this bacteria to just take over her arm," Bird said.

The girl's parents went to school officials to make sure they knew about the game and the potential dangers breaking the skin could lead to.

"Nobody had been aware of it (the ABC game) at all until then," said Marshall Topham, assistant superintendent for secondary education for the Washington County School District. "Every science class prepared a unit of instruction on this type of infection and the serious nature of this type of infection."

The teen has gone through more than 40 hyperbaric treatments and has about two dozen left to help the tissue and muscle recover with oxygen. She also faces two more surgeries.

The bacterium is common and lives on all people. It is not known why it affects some people and not others, Bird said.

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Information from: The Spectrum, www.thespectrum.com