A 19-year-old male was admitted to the pediatric intensive care unit (PICU) with shock, multiple organ failure, and a rash. He developed abdominal pain and vomiting 20 hours after consuming leftovers from a restaurant meal of rice, chicken, and lo mein. The symptoms progressed to chills, muscle pain, chest pain, shortness of breath, headache, neck stiffness, blurry vision, and skin discoloration.
The patient developed purplish skin discoloration five hours before admission and was taken to the emergency department of another hospital for evaluation. Upon examination, he had a severely high temperature and a pulse of 166 beats per minute and had to be sedated. The patient had a history of anxiety, depression, and recreational drug use, and his family had a history of coronary artery disease, hypothyroidism, and viral meningitis.
Upon arrival at the hospital, the patient underwent several tests and was administered intravenous medications, including ondansetron, ceftriaxone, and normal saline. Despite treatment, the patient’s breathing continued to worsen, and blood pressure decreased, prompting the initiation of a continuous infusion of norepinephrine.
Contamination by Neisseria meningitidis bacteria
The patient’s symptoms appeared to be caused by an aggressive bacterial infection. Specifically, his kidneys had failed, and his blood had started to clot. Based on his blood test results, doctors identified the presence of Neisseria meningitidis, a bacterium that can be found in the nose and throat of some individuals without causing illness. However, in some cases, these bacteria can invade the body and cause meningococcal disease, characterized by various symptoms.
The Neisseria meningitidis bacteria in the patient’s blood caused all of the blood vessels in his body to dilate, lowering his blood pressure and preventing oxygen from reaching his organs. This condition is known as Purpura fulminans, characterized by the abrupt appearance of skin bruises. The patient’s blood pressure was eventually stabilized, but he developed gangrene in the tissue of his fingers and toes, and as a result, his fingers and both legs were amputated below the knees.
The doctor discovered that the patient had received his first meningococcal vaccine before middle school but had not received the recommended booster shot four years later when he was 16.
Although it is unclear what caused the food to be contaminated, the evidence suggests that the presence of the bacteria was a freak accident. After 26 days, the patient regained consciousness, and his condition improved. Although his life has been significantly altered, he survived.
Preventing food spoilage: Guidelines for storing and handling perishable foods
It is recommended to refrigerate vulnerable foods such as meat, chicken, fish, dairy, and eggs to prevent such incidents.
Foods should not be left out for longer than two hours at average room temperature and no longer than one hour at temperatures exceeding 90 °C.
Cold salads or sandwiches should be eaten or refrigerated promptly to reduce the time a food is in the ‘danger zone’ between 40 and 140F (4 and 60 °C), where bacteria can multiply quickly.
Conclusion:The case warns the public about food safety and vaccination against bacterial infections. Following proper food storage and handling techniques is essential to stop bacterial development and the transmission of foodborne illnesses. Moreover, keeping up with recommended vaccination schedules to protect oneself against potentially deadly bacterial infections is crucial.
References
- Mahindra AS. Student loses all his limbs after eating roommate’s leftover noodles. Times Now. [Cited: 20 March 2023]. Available from: https://www.timesnownews.com/health/student-loses-all-his-limbs-after-eating-roommates-leftover-noodles-suffers-severe-bacterial-infection-blood-clots-article-98798074
- Wood T. Student lost all his limbs after eating his roommate’s leftover noodles for lunch. [Cited: 22 March 2023]. Available from: https://www.ladbible.com/news/student-limbs-amputated-eating-friends-leftover-noodles-903351-20230319
- A 19-Year-Old Man with Shock, Multiple Organ Failure, and Rash. NEJM. DOI: 10.1056/feature.2021.02.19.100086
- Teen Needs to Have Legs and Fingers Amputated After Eating Leftover Noodles and Rice, Developing Infection. Inside Edition. [Cited: 20 March 2023]. Available from: https://www.insideedition.com/teen-needs-to-have-legs-and-fingers-amputated-after-eating-leftover-noodles-and-rice-developing
