An aggressive pneumonia


October 23, 1990|By Dr. Simeon Margolis

Q: I was shocked and frightened by the sudden death of Jim Henson, the Muppets creator, from pneumonia. With all the progress that has been made in the treatment of infections, how could this happen to a healthy young man?

Henson's pneumonia was produced by an exceptionally virulent strain of group A streptococcus, a bacteria best known for causing strep throat. This particular aggressive strain of streptococcus has now been recognized as the cause of a new type of severe illness called toxic shock-like syndrome (TSLS) because of its similarity to toxic shock syndrome, caused by a different bacteria (staphylococcus), that felled young women using very absorbent tampons.

TSLS may begin as a mild sore throat or skin infection that rapidly progresses to a high fever and impaired circulation due to falling blood pressure. The illness can result in death or amputation even in otherwise healthy adults.

Fortunately, TSLS is relatively rare. Each year there are only about four or five cases for 100,000 people in this country, and only one in five of these has died. Also, Henson did not seek medical help for several days after he developed a high fever and other symptoms of pnemonia. He might have pulled through with earlier antibiotic treatment.

Antibiotics are no longer a sure thing in the treatment of bacterial infections. Many strains of bacteria have become resistant to multiple antibiotics as the result of their widespread use not only to treat human disease but also in animal feeds. Almost half the antibiotics produced in the United States are added in low doses to animal feeds in an effort to prevent disease or promote growth.

Dr. Margolis is professor of medicine and biological chemistry at the Johns Hopkins School of Medicine and associate dean for academic affairs at the school.

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