How a little infection can kill you

Here is a poem about a young girl.
Let us call her Miss Chidiogo
Because that apparently is her name
She was in coma when we first met
Very calm and worryingly so

She was not responding to touch or        pain
Not to calls by mum or dad
Not to injections as we had to give
And many injections we did give

She was hot to touch and sweating
Her face swollen and eyes bulging
She was in shock when we met
And close to death as it seemed
Unless we did something quite         quickly

So we offered her the knife
In theatre for surgery we did rush
To remove the pus that was on her        brain
As shown on the MRI scan

And day by day she returned to life
Turning corners to good health
Until today when I saw her again
Looking radiant in braids and a nice
frock
The coma was all forgotten and we reached a full stop.

The story
Of course, there is more to this story than a simple poem. Our heroine woke up one day with a swollen red eye. This followed a bout of flu, cough and catarrh the previous week. The cold had all but gone when this new problem started. So, off she went to the ophthalmologist who diagnosed an eye infection and started antibiotics. It did not get better and she was taken to see another ophthalmologist (Dr Stephen Ume) for a second opinion.
By this time, the forehead was involved and she was not quite right. Her head hurt and she had a fever. Dr Ume recognised that this was not just a simple eye infection and referred her for neurological evaluation, admission and care. This turned out to be the life saving decision because shortly afterwards, she stopped talking and went into coma. An urgent brain scan revealed that she had infection of the eye and the sinuses extending through the bone into the brain. The brain was swollen and under pressure due to copious amount of pus from the infection.
This condition is called an acute subdural empyema. It means pus on the brain for short and could lead to seizures, stroke, coma and death if not properly treated. Early recognition and effective treatment with surgery and antibiotics save lives. Delay could lead to permanent injury, disability and death.
In view of the seriousness of the condition and the fact that she was already in coma, there was little option but to operate. The operation entailed removing the bone over the forehead and washing out the pus on the brain and in the sinuses. We also washed everything in antibiotics and then put it all back together again. Thereafter, she continued on serious antibiotics for 3 months to ensure that the germs were killed permanently.

How a little infection can kill you?
Infections like this can lead to what we call sepsis. Sepsis is an extremely serious condition which is caused by an overwhelming reaction of the body to infection. The infection prompts the body to release chemicals as a defence mechanism. However, the chemicals themselves can cause widespread inflammation which can then damage the body organs.
In the worst cases, the infection leads to a life-threatening drop in blood pressure, called septic shock. This can quickly lead to the failure of several organs including the lungs, liver and kidney, causing death.

Common symptoms and signs of sepsis
Some of the symptoms include
• High temperature• Low blood pressure• Confusion and sickness• Lightheaded and coma
Who can get it?• Anyone can get sepsis. A minor cut, scrape or a bug bite that was ignored can set off the deadly cascade.
Why is it so dangerous?• Every hour raises the risk of death by eight percent if the sepsis is untreated• At least 50 percent of septic shock patients do not survive• Vital to get treated as soon as possible
How is it treated?1. Broad-spectrum antibiotics, these are medicines that kill many types of bacteria.
2. Oxygen and intravenous fluids

In conclusion
The truth is that a little infection can lead to much misery and death if ignored. A little thing like the flu, common cold, catarrh, mosquito bite, bug bite and even that nail puncture can be the harbinger of misfortune. A man who stepped on a fish bone nearly died 2 weeks later from sepsis through the tiny wound on the sole of his feet! Carelessness can be perilous.
Sometimes, it is self medication, a visit to the local chemist or an unsuspecting medical doctor that makes a little issue assume mammoth proportions. Sometimes, it is ignorance and nonchalance that compounds the problem. Sometimes, it is articles like this that save lives.

NB: Not everyone in a white coat is a doctor: Always ask for a real doctor!
Acknowledgement: The information on sepsis came from Dr Rotimi Jaiyesimi and the Rory Staunton Foundation.