A Little Hysteria Never Hurts Anyone by Pat Conrad MD

An Indianapolis woman died last week from necrotizing fasciitis, a truly sad story.  Following a vacation to Florida, she noticed a sore on her buttock.  Two visits to her primary doctor for antibiotics and heating recommendation, then to the hospital when it worsened.  Between news accounts and some pretty sloppy journalism, it’s tough to tell exactly who did the biopsy when the area worsened.  The primary, the ER, infectious disease after she was admitted?  We can’t say.  She was diagnosed, and admitted to the ICU for 16 days following surgery.  The patient was then released home where she made lunch (the next day?) for her husband, who found her that afternoon, dead.

The episode is tragic, and the husband is understandably grief-stricken.  So it does not help that a huff-huffing media cannot present a cogent timeline in its rush to scare with another ‘Flesh-eating Bacteria!!” headline.  And it does not help any of us for the media to include in the lead paragraph, “… but her husband believes she would still be alive today if doctors had diagnosed her earlier.”  While technically possible, it implies the doc in the office somehow blew it by not doing a tissue biopsy for a condition that would not have clinically warranted it at the time.  And the slobbering reporters just had to include this from her husband:  “He told Tampa television station WFLA that he thinks his wife may have contracted the bacteria from a hotel’s hot tub.’My thing is, nobody else got it, the flesh-eating bacteria. She was the only one that got in the hot tub,’ he said.”  Or she might have gotten in in any of a thousand other spots in a state where MRSA is practically airborne (believe me, I live here).

What were the patient’s co-morbidities, if any?  Was she clinically stable the day of discharge, and was she feeling better?  Was it the infection that killed her, or did she develop a pulmonary embolus while in the ICU?  The coroner has not yet said, and the hospital is appropriately mum.

A friend of mine observes of such cases that “living is a dangerous business,” and he’s right.  I’m not calling for restrictions on freedom of the press, and I’m sorry for the husband.  But chumming all the water for shark lawyers with a bunch of half-reporting is not going to bring her back, is not going to prevent the next such death, and will keep the rest of us just that much more anxious to do a biopsy absent any clinical indication.

Want to laugh some more?  Read Dr. Farrago’s “Diary of a Drug Rep”