I’ve mentioned a few times the work of Ignaz Semmelweis in preventing “childbed fever” in new mothers. To recap:

Semmelweis was a physician in Vienna in the 1840s, with an interested in “childbed fever,” a leading cause of mortality in women who’d given birth. During this time, he noticed that the mortality rate from this disease in a hospital division where medical students delivered babies was 16%, while in a division where midwives delivered them was ~2%. It was also known that childbed fever was rare when women gave birth at home. Semmelweis thought there was something the med students were doing that served to raise the rates of childbed fever in those divisions.

In 1847, Semmelweis’ friend, another physician, died due to a wound acquired while performing an autopsy. Semmelweis examined the tissues of his friend, and noticed the pathology there was similar to those in women who’d died of childbed fever. According to history, this led to his “eureka” moment: medical students performed autopsies, and midwives did not. The students must be bringing some contagious agent from the autopsy room back to the delivery room.

This contagious agent was later found to be the group A streptococcus, Streptococcus pyogenes. Since the early 1990s, this bacterium has regained notoriety due to its ability to cause what the media has dubbed “flesh-eating disease” (or to those who speak medical-ese, necrotizing fasciitis). In a strange and tragic story, it seems that streptococcus has struck again in a young mother, sparing her life but costing her arms and legs:

A Sanford mother says she will never be able to hold her newborn because an Orlando hospital performed a life-altering surgery and, she claims, the hospital refuses to explain why they left her as a multiple amputee.

The woman filed a complaint against Orlando Regional Healthcare Systems, she said, because they won’t tell her exactly what happened. The hospital maintains the woman wants to know information that would violate other patients’ rights.

Claudia Mejia gave birth eight and a half months ago at Orlando Regional South Seminole. She was transported to Orlando Regional Medical Center in Orlando where her arms and legs were amputated. She was told she had streptococcus, a flesh eating bacteria, and toxic shock syndrome, but no further explanation was given.

Mejia said after she gave birth to Mathew last spring, she was kept in the hospital with complications. Twelve days after giving birth at Orlando Regional South Seminole hospital, she was transported to Orlando Regional Medical Center where she became a quadruple amputee. Now she can not care for or hold her baby.

Privacy laws obviously aren’t my area, so I don’t know whether the hospital is actually complying and trying to protect the privacy of another patient, or is trying to cover their own ass because one of their employees unknowingly transmitted streptococcus from one patient to another, eventually resulting in Mejia’s amputations. The first patient wouldn’t even necessarily have had to suffer from toxic shock syndrome or necrotizing fasciitis; just having streptococal pharyngitis (“strep throat”) could be enough to infect Mejia with the bacterium. In most people, strep won’t cause this deadly invasive disease, but already being stressed from childbirth and potentially having open wounds would increase her susceptibility to these serious manifestation.

However, this being just a news story and all, there are a lot of gaps; most notably, what happened between the day she gave birth and the day she was transported to Orlando Regional Medical Center for surgery (12 days later)? If she developed streptococcal toxic shock syndrome, necrotizing fasciitis (the story doesn’t mention that specifically, though it mentions “flesh eating bacterium,”), or both, there could have been at least two reasons to amputate that I can think of. One, the drop in blood pressure due to toxic shock could have caused tissue death in the distal parts of her anatomy (her limbs), necessitating amputation; or two (and seemingly less likely to me), the bacterium somehow infected all four of her limbs, and there was enough tissue damage and bacterial spread that they needed to amputate to stop the bacterium in its tracks. There certainly may be other scenarios as well; I’m obviously no surgeon. Either way, while it’s tragic, the case fatality rate for streptococcal toxic shock syndrome can be as high as 70%, so even without her limbs, she’s still fortunate to be alive to see her kids grow and have them ask her questions about what happened to her.

Comments

  1. #1 ben
    February 1, 2007

    I despise the tendency to tell people who have suffered a grievous misfortune how fortunate they are. Whatever happens to you, however bad it is, there’s always someone saying “oh, it could have been worse, you could have been eaten by a dragon.”

  2. #2 Tara C. Smith
    February 1, 2007

    Sorry, didn’t mean it that way–just that given the statistics on this disease, she had about a 1 in 2 chance of not being around at all. I realize that doesn’t minimize her suffering.

  3. #3 SH
    February 1, 2007

    More recent information about this case is available here:

    http://tinyurl.com/3ygzuc

  4. #4 Tara C. Smith
    February 1, 2007

    Ah, I hadn’t noticed it was last year–I just saw the January date. Wonder if they ever did molecular typing on her strain…

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