A 19-year-old student had both of his legs and all 10 fingers amputated after he ate leftover food, which triggered a potentially fatal disease.
In a recent video shared to his YouTube account, New York-based pain medicine specialist and anesthesiologist Dr Bernard Hsu, who goes by the username Chubbyemu, detailed a case study first published in The New England Journal of Medicine in March 2021.
According to the case, the 19-year-old man - referred to as JC in Hsu's video - was admitted to the Massachusetts General Hospital's paediatric intensive care unit (PICU) due to "shock, multiple organ failure, skin mottling, and a rapidly progressive reticular rash".
The teenager, who began to feel unwell 20 hours before his admission, developed abdominal pain and nausea after he ate chicken, rice and lo mein leftovers from a restaurant. JC subsequently vomited multiple times before developing chills, weakness, chest pain, shortness of breath, headache, neck stiffness and blurry vision.
Five hours before his admission, the 19-year-old's friend took the patient to the emergency department (ED) at a different hospital for evaluation.
After arriving at the ED, 4.5 hours before he was hospitalised at the PICU, the patient reported diffuse myalgias - muscular pain and tenderness - that he rated an eight on a scale of zero to 10, with 10 indicating the most severe pain. He also vomited "yellow-green material".
Following the initial examination, JC's breathing became progressively rapid and laboured and his blood pressure continued to drop. Following the teen's sedation, doctors noticed the development of a "diffuse purpuric rash" across the majority of his body and two hours after his arrival, he was transported by helicopter to the Massachusetts General Hospital. Photos of the patient's rash show deep purple spots across his abdomen, arms and legs, similar to bruising.
Following further testing, it was determined that JC had contracted neisseria meningitidis, often referred to as meningococcus - a bacteria that can cause meningitis and other forms of meningococcal disease.
According to the Centers for Disease and Control Prevention (CDC), the neisseria meningitidis bacteria that causes meningococcal disease can first appear as a flu-like illness and rapidly worsen. Meningitis caused by the bacteria, meningococcal meningitis, includes symptoms such as fever, headache, a stiff neck, vomiting and confusion.
Elaborating on JC's dark purplish rash, Dr Hsu explained it was purpura fulminans, an acute purpuric rash in which small spots of blood appear on the skin. According to the Canadian Medical Association Journal, purpura fulminans can be a severe and rare result of meningococcal disease.
Although this is not noted in the case study, Dr Hsu explained that the JC's severe skin infections had started to necrose - when the cells die due to disease, injury, or failure of the blood supply. As a result, both of his legs and all 10 of his fingers were amputated.
JC's roommate had also consumed the leftover food and vomited, but hadn't become progressively ill. The doctors then obtained additional medical history from JC's family to determine why he had suffered such an extreme reaction.
According to the case study, JC had reportedly received all routine childhood vaccinations. However, Dr Hsu - who claims the cases he covers are patients either he or his colleagues have observed- said JC had only received the first dose of the meningococcal vaccine shortly before he entered middle school, and not the booster recommended four years later at age 16.
A second, Serogroup B meningococcal vaccine is usually required for people between the ages of 16 to 23, which also consists of two separate doses administered a few months apart. According to Hsu - which again wasn't outlined in the case study - JC had again only received one dose.
Hsu said it remains unclear how the neisseria meningitidis bacteria had contaminated the food. According to the doctor, JC's condition began to improve after a few weeks and he has since recovered.
According to WebMD, bacteria can quickly grow on leftover food when it's stored at room temperature and food should be put in the fridge or freezer within two hours after it's "been cooked or taken off a heat source".
