From heart palpitations to shaky hands, we all have moments when our bodies move without our control. Still, these sensations tend to pass quickly without raising any alarm bells – except in the case of a 27-year-old man in Canada, who couldn’t ignore what was happening.
A spot on his hand hurt and throbbed so much that it drove him to the emergency room. Doctors examined his palm and determined that it – and a slew of other symptoms – signified that something much worse was going on.
For six weeks prior to his hospital visit, the man in question had suffered a laundry list of ailments. He had experienced a fever, sweat through the night and felt such a drop in his appetite that he lost 26 pounds. And then, there was the bump on his hand.
It started out as an erythema, which is your average dermal redness caused by anything from an injury to allergies, from exercise to waxing unwanted hair. Rather than fading away, though, the area became blue and raised.
The bump started pulsing and felt painful, too. It was enough to drive the 27-year-old to the emergency room, where doctors immediately began conducting tests. They came back with unexpected results: the man had a heart murmur.
But that was only the beginning of the diagnoses he would receive. Doctors also found that he had a high white blood cell count. This can indicate that a person is fighting infection, or that they have bone marrow disease or an immune system disorder.
They then delved deeper into their inspection of the man’s heart. They used an echocardiogram, which painlessly sends sound waves into the organ to map its structure and see if any area of the heart is underperforming.
This test revealed that the 27-year-old had more to worry about than a heart murmur: he had a partial blockage of one of the organ’s four main valves. And then, of course, there was the case of the pulsating hand, which was caused by another cardiac issue.
A computerized tomography (CT) scan revealed that the lump wasn’t just a bit of raised skin: it was an ulnar-artery mycotic aneurysm. The puffiness stemmed from swelling on a major blood vessel in the hand. Doctors could also see that parts of one kidney and the spleen had lost so much oxygen they had died.
To the untrained eye, these symptoms might seem unrelated, but doctors knew that there was an underlying cause to all of these problems: endocarditis. This condition begins when bacteria makes its way into the bloodstream.
The bacteria then begins sticking to the heart valve lining in groups called “vegetations.” The trouble really starts when vegetations detach from the valve lining, and then travel through the arteries where they can get stuck. These blockages can cause aneurysms.
And while that happens, bacteria continue to course through the veins spreading infection to different areas of the body. This is what causes side effects like night sweats and weight loss, both of which were listed as symptoms by the man in the Canadian hospital.
His doctors were able to pinpoint the bacteria that had caused all of his problems: a mouth-based strain of streptococcus had made its way into his bloodstream. Different strands of streptococcus cause pink eye, strep throat and meningitis, among other ailments.
The medical team had one surprising explanation as to how this common mouth-borne bacteria could have made its way into his body to cause such problems: he could have had a space in his gums that let in the streptococcus.
Subpar dental hygiene or faulty dental procedures could have caused these cracks. And, despite many mouth-based bacteria not being harmful at first, these types of openings give them a chance to cause harm in places of the body that are defenseless against them.
Although dental hygiene could be to blame, the chances of that happening are actually quite slim. It’s more common that those with heart defects or implants suffer from this kind of infection because they have more places for bacteria to cling within their valves.
But the man in the Canadian emergency room didn’t have just one of these pre-existing conditions: he had all of them. Before he started experiencing the symptoms of endocarditis, he had had a dental procedure and a long history of neglecting the care his gums needed.
On top of that, he had a heart condition of which he was not aware. He had a slight difference in his aorta: the normal person has three valves within the aorta, but he only had two. This made him more susceptible to the infection he suffered.
Fortunately, the 27-year-old’s doctors caught it in time and were able to send him into surgery to fix his aneurysm and restore his aorta. They also prescribed antibiotics in order to fight the infection that had caused his problems in the first place.
From then on, he would have to continue taking antibiotics every time he went to the dentist to prevent any more bacteria from sneaking into his bloodstream. But perhaps the most important lesson to be learned from his story is the fact that symptoms as severe as his always warrant a trip to the doctor’s office or the emergency room – that move saved his life.