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Meningococcemia - odd story (nyc)

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  • Meningococcemia - odd story (nyc)

    'You're Very Ill' Takes a Sudden Turn to 'You're Very Lucky'
    http://www.nytimes.com/2006/03/21/health/21case.html
    By PHIL HANRAHAN
    Published: March 21, 2006

    The night before, I felt like a million bucks. I jogged home from work, from Midtown Manhattan to Astoria, Queens, crossing the 59th Street Bridge on a warmish winter evening.

    In the morning, my back was stiff. I figured I slept wrong, or maybe pulled something running home. An hour later, I nearly passed out on the subway.

    Reeling onto a platform just one stop closer to my destination, I used a pay phone to call a colleague just back from the flu. I described symptoms. Stiff back. Light-headedness. An overall deeply weird feeling. He said, "Yeah, could be what I had."

    My doctor agreed it could be the flu when I saw him 10 days later. "It's going around," he said. "Bad bug this year." He'd already seen three or four of my colleagues.

    That night I finally invested in a thermometer and took my temperature during one of the nightly fevers that for just a few minutes at the start were a welcome relief from chills that had me shaking under five layers of clothing, ski cap on my head.

    105.5. Just as shocking as the number was my perception that this fever was no different ? no more raging ? from the previous half-dozen.

    I went back to my doctor. There were also night sweats to report. And excruciating bone and joint pain, migrating arthralgias that felt like fractures.

    My doctor prescribed Vioxx.

    Two days later, I was back. Small purple blotches covered my body. Also, my feet were starting to swell. And, um, it seemed hair was falling off my shins.

    My doctor and a colleague examined me. They speculated the rash could be a reaction to Vioxx. They mentioned Lyme disease, lupus, early arthritis.

    Blood work indicated the obvious: inflammation. But was it an autoimmune disease? A mystery infection? How about a kidney abscess? The M.R.I. scan was normal.

    My doctor sent me to an infectious disease specialist. After a few minutes of questions ("Have you been to the tropics?"), I hobbled out, no wiser.

    Twenty-five days had passed. Fevers had burned 15 pounds off my runner's frame, leaving me emaciated. I still had the rash. At work, I haunted the 10th floor like a ghost.

    My mother wanted me to come home. I went home. Within minutes of entering my parents' house in suburban Milwaukee, I lay curled in a fetal position before a living room fire, teeth chattering so hard I could barely speak. My mother took one look at me and said, "We're talking to Bill."

    Bill was the doctor next door. He had known me since I was 10. He had been my orthopedic surgeon the summer of my 16th year, when I broke my neck in a diving accident. Bill came over. Bill examined me. Bill said, "You're very ill."

    I agreed. Then Bill said, "I think you should see Marcia." Marcia was a general practitioner with the instincts and doggedness of a detective, he explained. She liked hard cases. She would get to the bottom of this.

    I saw Marcia that day. She listened for a full half-hour, taking copious notes. She zeroed in on my rash, diagnosing vasculitis, an inflammation of the blood vessels that can be a secondary symptom in certain kinds of serious infections.

    Then came the moment, the educated guess: "I think I know what it is. I've never seen it, but I've read about it. Chronic meningococcemia. We need to test your blood."

    My blood was tested. An hour after results confirmed her suspicion, I was in a hospital bed, hooked up to an IV, antibiotics destroying the bacteria that had made me sick for nearly a month now. My heart was scanned. Luckily, the infection had done no damage.

    Acute meningococcemia can kill you within hours. The chronic variety can be deadly if the sepsis crosses the blood-brain barrier, and the heart can be affected. Most people have immunity. For those who don't, you can catch it from a sneeze.

    I spent five days in the hospital, then returned to New York, where I spent the next six weeks with an IV port in my arm, self-dosing before and after work.

    A couple weeks after my last IV, the New York City Health Department called. A very serious woman on the other end of the line had some questions. Feeling fantastic by this point, I spoke rather breezily of what had gone on, laughing at the sillier symptoms, conveying an overall attitude of "Hey, what can you do? Life in the big city."

    Only two people in all of New York were officially known to have contracted chronic meningococcemia that winter, she told me when I was done chuckling. "Lucky me!" I responded.

    Then a question occurred to me. "How's the other person?"

    "The other person," she said after a brief silence, "did not do as well."

  • #2
    Re: odd story (nyc)

    I posted this story because it is so similar to what my own 24-year-old daughter (from Philadelphia) experienced. She tested positive for "influenza a" followed by her knees, ankles, and wrists becoming swollen with severe bone-breaking pain and a rash. (she said she felt like "polio-boy")

    Her doctors also speculated that it was RA, lupus, or a drug reaction and she was also sent home with a pain reliever. Three doctors said they had never seen anything like this before.(?) Other complications included heart murmer, pleuritis, vasculitis, cellulitis, ganglion, baker's cyst, fast dropping RBC, and elevated liver enzymes. Finally, after 5 days of hospitalization and antibiotic treatment things started to resolve, although it took several weeks for her to walk normally again.

    A month later, follow-up blood tests showed tick-borne ehrlichia so she was given further antibiotic treatment. (although she recalled no tick bite)

    I continue to wonder what is going on with reports of "mystery infections" with severe arthralgias and rashes that seem to be misdiagnosed. I wonder where they are coming from?

    Comment


    • #3
      another odd story (nyc)

      http://www.nypost.com/news/regionalnews/63890.htm
      April 2, 2006 -- A teacher at Bronx Science HS has con tracted tuberculosis, making her the latest victim in a series of maladies that have plagued the school in recent years.

      No other cases of TB have emerged, but hundreds of students at the prestigious public high school may wind up being tested.

      The infected staffer came down with the disease about two weeks ago. The teacher is responding well to medication, but how she got the disease is still under investigation.

      "Is she contagious? I don't think they know yet. It's pretty scary," said Marjorie Marchione, whose son Jason is a junior.

      The TB came to light a year after an outbreak of a mysterious virus that left 400 students and 10 teachers laid up for days complaining of vomiting and diarrhea.

      At the time, health officials said they suspected one of two respiratory viruses. But the cause of the outbreak has never been determined - nor was the school quick to inform students what was going on, students say.

      "They didn't want us to know much, like this wasn't a big deal," said a student named Michelle, who was out sick for a week.

      "My daughter's a junior now. I hope she can make it through graduation without any new health threats," Michelle's mom told The Post.

      Five months prior to the viral outbreak, two teachers contracted rickettsialpox, which is caused by bites from mites that live on rodents.

      In that case, too, Principal Valerie Reidy wasn't forthcoming about the disease, sources say. Only after one faculty member threatened to file a grievance did Reidy issue a letter to staffers and parents.

      In it, she wrote: "Two Weeks, ago a staff member reported that she had been absent for a week due to . . . rickettsialpox . . . Last night, another staff member called to report that she had contracted the same illness."

      Reidy then outlined the school's plan for dealing with "our rodent problem," which included laying down glue traps over the weekend.

      "All procedures were followed accurately and appropriately, according to Department of Health protocol," Reidy told The Post.

      Rickettsialpox victims typically develop skin lesions within two weeks. They may also develop Fever, headaches and myalgias. Treated with antibiotics, the rare disease is not contagious, and no fatalities have ever been reported.

      The DOH notified students, parents and faculty of last month's TB case by letter about 10 days ago.

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