08 December 2008

It's flu season: Watch for MRSA pneumonia.

Via the (Tucson) Arizona Daily Star, I've just caught up with the very sad story of Robert Sweitzer, a Tucson resident who died on his 39th birthday, of MRSA pneumonia.

Sweitzer died last Feb.10, but his name is in the news now because a lawsuit filed by his wife Rachel against the hospital where he died has just been scheduled for a Sept. 2009 trial.

The apparently undisputed facts of the case (according to news reports that I cannot usefully link to because they require registration) are:
  • Sweitzer was a healthy man, married three years, who worked a full-time job and devoted all his spare hours to animal rescue.
  • On Saturday, Feb. 9, he woke up feeling as though he were coming down with a cold, with a cough and low back pain. He and his wife went to a regular volunteer shift at a local cat shelter, but by evening, he was having trouble breathing. They arrived at St. Mary's Hospital ER at 6:30 p.m.
  • Sweitzer was triaged within a half-hour, judged to be a low-acuity case, and sent to wait.
  • It was February, the height of a bad flu season, and the ER was slammed with 170 patients.
  • Sweitzer's breathing and back pain got worse and his wife twice asked unsuccessfully for him to be re-evaluated.
  • When he was finally seen at 2:30 am, an X-ray showed his lungs filled up with fluid. He was put on 100% oxygen.
  • He arrested twice and was pronounced dead near 7 a.m.
Following an autopsy, the Pima County Medical Examiner and the Arizona Department of Health Services asked the Centers for Disease Control and Prevention to evaluate Sweitzer's case; based on the extensive lung destruction, they feared he died of hantavirus. Tissue samples were sent to the CDC, which reported in August that Sweitzer actually died of necrotizing pneumonia caused by MRSA.

We have talked before (here, here, here, here and here) about the particular danger of MRSA infection during flu season, when (it is theorized) micro-trauma to the lungs by flu infection allows MRSA to gain a foothold. Once it begins, MRSA pneumonia proceeds with incredible speed — I have spoken to parents whose children went literally from apparently healthy to dead or close to it, within 24 hours — and it is commonly mistaken either for flu or for community-acquired pneumonia, the usual drugs for which have no impact on MRSA.

So, constant readers: It is flu season. Please get a flu shot. The observations and research on this are still limited, but it does appear that if you prevent flu, MRSA will have a more difficult time gaining a foothold in the lungs. (And if you nevertheless find yourself in a situation similar to Robert Sweitzer's, and you truly believe it is life-threatening for yourself or your loved one, do whatever is necessary to direct clinical attention to you in time.)

Because I cannot link through to the Arizona Star stories, here are the dates and headlines:
  • 20 February 2008, "His pet projects: rescuing dogs, cats," byline Kimberly Matas
  • 16 March 2008, "39-year-old's ER death leaves a lot of unanswered questions," byline Carla McClain
  • 27 August 2008, "Feb. death of Tucson man, 39, tied to staph," byline Stephanie Innes
  • 1 December 2008, "Suit over death at St. Mary's ER set for trial in September" (no byline).

1 comment:

Anonymous said...

We have a series of defense mechanisms a natural hierarchy to keep the germs at bay any damage or weakening and stressors that disable the immune system make the germs assault that much easier.I often hear the remark that a single cause is to blame ,a mantra that is misleading.Multiple factors are what brings about the demise of the victim.Germs also evolved before the modern use of antibiotics it has simply accelerated the speed of evolution of the new bugs.Modern travel and disturbing natural areas of vegetation to unleash previously contained bugs to spread their destructive path through our modern world.