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Medical Question: Glad FluTrackers is on the web

mickey

Member
I have read the Flutrackers site for several years, bless all FluTrackers for their work. I am troubled about a case that happened in our town and am not sure where in FluTrackers it should go, so I am putting it here.

One our daughters is a coronary critical care nurse in a large hospital in our town, and had a case on January 13th, 08 that I thought warranted a discussion. If you are indeed having breakfast while reading this, skip the description. Many of our family members are in the medical profession and our daughter called to see what they thought might have caused these symptoms.

The patient decription :

sex - female, age early sixties, general health - not good. She had chronic obstructive pulmonary disease, had been in the hospital for a couple of days.

The strange part is that on January 15th, 08 the patient developed pneumonia and was put on a ventilator, spiked a white blood cell count of 45,000 and a RECTAL TEPERATURE OF 107.1 !!!! Her skin became mottled and dark, her eyes were bright red, she had kidney failure and bleeding from the mouth. The patient died. the nurses said she looked like Freddy Kruger (sp?).
No nurse in the critical care unit had ever seen anything quite like this.

One of the disturbing things about this case is that my daughter called doctor after doctor after doctor and could get no-one to come look at this patient. NONE of the woman's doctors would come to the hospital. As usual, each specialist told my daughter to call another type of specialist.

One doctor, over the phone said, "that would may a heck of an autopsy" but didn't order one.

the mortuary assitant balked a bit at taking the body back to the mortuary.

And so:
In a major affluent hospital in a large town in the United States, a woman died of very strange symptoms and no-one paid attention. No doctor would come to see her. If I knew how to post icons, i would put very sad ones here. :( :( :( :( (added by hawkeye)
I think perhaps morticians could help us look for the beginning of a pandemic, instead of the doctors.
 
Last edited by a moderator:
Re: Glad FluTrackers is on the web

Re: Glad FluTrackers is on the web

Mickey Welcome!

I am going to move this thread to the discussion forum.
 
Re: Glad FluTrackers is on the web

Re: Glad FluTrackers is on the web

You raise a good point. I wonder if there are more cases like this out there? Inexplicable deaths should always be sent for autopsy. Too bad they aren't. In a situation where we are talking about one case and one death in an older and chronically ill patient, I suspect there is little push to solve a case. If however, there were more than one, especially in cases of healthy persons, we would see more impetus to examine the deaths more thoroughly.
 
Re: Glad FluTrackers is on the web

Re: Glad FluTrackers is on the web

Fla, I think we need to change the name of this thread to reflect its content. What say you?
 
Re: Glad FluTrackers is on the web

Re: Glad FluTrackers is on the web

Sure.

I have to run to a meeting. Can you do it?


S.
 
Re: Glad FluTrackers is on the web

Re: Glad FluTrackers is on the web

Mickey, not sure if this will help . . . but the symptoms you describe are consistent with septic shock (septicemia) secondary to a bacterial pneumonia.

Of course, no one one can make a diagnosis from afar, but the symptoms are not all that unusual.


Septicemia is generally suspected when a patient has a significant fever, a white count over 12,000, and rapid breathing. Blood cultures take about 72 hours to mature, so usually a broad spectrum antibiotic (levoquin commonly used) is begun.

The mottled skin, red eyes, and bleeding from the mouth may indicate DIC, or Disseminated Intravascular Coagulation, a not uncommon symptom seen with Septicemia.

DIC is process where the blood starts to coagulate throughout the whole body. Paradoxically this depletes the blood of platelets and clotting factor, increasing the risk of hemorrhage. It can occur in critically ill patients, especially those with Gram-negative sepsis.

And Gram negative pneumonias generally attack those in hospital or nursing home situations, or those whose health is poor.

Anyway, the symptoms you described, while severe (and usually fatal), are not uncommon when someone is overwhelmed by a systemic bacterial infection.

The reluctance to do an autopsy may have more to do with opening liability issues than anything else. But that's pure supposition.


Hope this information is of some value to you.
 
Re: Glad FluTrackers is on the web

Re: Glad FluTrackers is on the web

Welcome mickey. Thank you for the info FLA_MEDIC
 
Re: Medical Question: Glad FluTrackers is on the web

Hi FLA_MEDIC,

Very nasty thing.

"critically ill patients, especially those with Gram-negative sepsis.
And Gram negative pneumonias generally attack those in hospital or nursing home situations, or those whose health is poor.
Anyway, the symptoms you described, while severe (and usually fatal), are not uncommon when someone is overwhelmed by a systemic bacterial infection."

Can you please answer, if the Pneumo vaccine will shield the patient from Gram negative pneumonias in a septic systemic bacterial infection?

If not, exist another kind of vaccine for that?

Can we expect that the such an septic agent (gram neg., or pos.) will stay in the blood (and be traceable by a blood culture) in the event of a succesfull wide-antibiotic therapy (after the finishing of the 1 month antibiotic therapy; without temperature) also,
or it was definitively extirpated out of the bloodstream of the patient, and it's not necessary to control the blood with a culture 1 month after that?

Thank You!
 
Re: Medical Question: Glad FluTrackers is on the web

Tropical,

As far as I know, the Pneumovax II 23 valent vaccine only protects against gram-positive pneumonias, and even then, not 100%


This from the web site US PHARMACIST

http://www.uspharmacist.com/index.asp?show=article&page=8_1015.htm



The 23-valent polysaccharide pneumococcal (23PS) vaccine, Pneumovax, or the newer 7-valent vaccine, Prevnar (PCV7) can help prevent incidences of community-acquired pneumonia caused by Streptococcus pneumoniae. The 23-valent polysaccharide pneumococcal vaccine, which has a prevention rate of 56%-81% for pneumococcal infections, contains 16 more serotypes of Streptococcus pneumoniae as compared to Prevnar and therefore provides additional coverage over the conjugate 7-valent pneumococcal vaccine.


Streptococcus pneumoniae, or pneumococcus is a gram positive bacterium.

I'm hardly an expert in this field, but I'm unaware of any gram negative pneumonia vaccines.

Hopefully someone else may weigh in with more info.
 
Re: Medical Question: Glad FluTrackers is on the web

Thank You very much FLA_MEDIC!

With those infectious illness proliferations, a surge in various resistant hospital infections, and the other various nasty illnesses, life seems to became like 100 years ago, or more.

My best health wishes,
t.
 
Re: Medical Question: Glad FluTrackers is on the web

An article on the pathogenesis of sepsis arrrived with some automated searches this a.m. :

http://www.bmj.com/cgi/content/full/326/7383/262?ct

The summary points are below. I'm not sure if this is also relevant to ongoing discussions in othe threads about cytokine response:

J.

_________________

Summary points


--------------------------------------------------------------------------------
Bacterial cell walls, endotoxins, and exotoxins are powerful activators of innate and acquired immune responses

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Molecules expressed by pathogens interact with Toll-like receptors on immune cells, activating the immune response

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Cytokines are important in the pathogenesis of sepsis

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Susceptibility to sepsis may be due to inherited or acquired mutations of innate immune genes

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Severe sepsis and septic shock are clinical manifestations of a dysregulated immune response to invasive pathogens

--------------------------------------------------------------------------------
Adjunctive therapy with low dose steroids, activated protein C or early supportive care can reduce mortality from severe sepsis and septic shock

--------------------------------------------------------------------------------
Pathogen recognition receptors (such as Toll-like receptors) and mediators of sepsis (such as macrophage migration inhibitory factor) might be novel targets for treatment
 
Re: Medical Question: Glad FluTrackers is on the web

Thanks to all for the interest in this case. Sepsis came to our minds too. A point can be taken from this case, that horrible stuff could lurk in at least some of our hospitals and go under-reported. Excess deaths in an area are good to watch; along with doctor's reports. :(
 
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