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Stomach Pain and Appendage Amputation.


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How does a father go to the hospital for stomach pain, then leave without both his hands and feet? According to this Washington Post article, strep throat is how. The virus reportedly traveled from the patient's throat to his stomach where it multiplied, spread to other organs, and caused multiple organ failures. The patient's physician, Dr. Elizabeth Steensma, says "'It's estimated that there are over 1 million cases per year, and this is only the second case that has ever been reported of strep traveling from a male patient's throat to his stomach'”.​ I wonder why women are more susceptible than men? It was a fascinating story and compelling caveat for men to be more attentive to their perceived minor illnesses.

Edited by DrmDoc
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Since they don't know the difference between a virus and a bacterium, it's not sure how far we can trust this report.

 

It's also common practice for Drs not to refer in any detail to the patient's identity when discussing a patient so the "a male patient" is pretty much irrelevant here

There are millions of cases of strep throat; very few (thankfully) migrate to the gut.

There's no clear reason to believe that there's a difference in the rates of this happening in men and women.

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Since they don't know the difference between a virus and a bacterium, it's not sure how far we can trust this report.

 

It's also common practice for Drs not to refer in any detail to the patient's identity when discussing a patient so the "a male patient" is pretty much irrelevant here

There are millions of cases of strep throat; very few (thankfully) migrate to the gut.

There's no clear reason to believe that there's a difference in the rates of this happening in men and women.

 

The error was mine in referencing the article, strep is indeed bacteria. Given the pictures of the patient with his family in this article, his sex and identity was likely revealed with his permission. Although this patient's identity is irrelevant to you, this was a Washington Post article and his identity was plausibly revealed as a way to personalizing this story for a general audience rather than professionals. Indeed, the article didn't make a clear statement on rates of occurrence between men and women; however, Dr. Steensma's comments, if not hyperbole, regarding this patient being "only the second case that has ever been reported of strep traveling from a male patient's throat to his stomach" ​from a million such cases reported yearly suggests to me a rarity of this particular occurrence among men. I'm not aware of any statistical differences between men and women on this specific illness, but it's not unlikely that such statistics are kept. If there are differences, I believe it merits further investigation.

Edited by DrmDoc
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Actually, the articles says that have only been 32 cases of (I assume) Streptococcus infecting stomach (though the description is rather vague). The million is probably referring to regular infections. So while there have been more female cases, the overall number is so low that it could have been pure chance. I.e. there could have been secondary infections, immune system issues etc. Again, not enough details in the article for any level of speculation.

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Actually, the articles says that have only been 32 cases of (I assume) Streptococcus infecting stomach (though the description is rather vague). The million is probably referring to regular infections. So while there have been more female cases, the overall number is so low that it could have been pure chance. I.e. there could have been secondary infections, immune system issues etc. Again, not enough details in the article for any level of speculation.

 

Details matter, you're quite correct. Indeed, it was two out of 32 cases rather than millions. Although it's a rare occurrence, the higher incident of this condition among women suggests some immunity among males over females. If only for the edification of the small percentage of affected individuals, I continue to believe this suggested immunity merits further study.

Edited by DrmDoc
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As I said, due the low numbers of incidences (32 out of probably a few millions, as time frames have not been mentioned) inferring differences is probably not terribly significant. Also, it can also mean that there is something different in the 32 or individuals as compared to the million or so other infections. Thus, even if you infer something, it you cannot generalize the finding. And finally, without further health data, you cannot latch on the only information you got (i.e. gender) as there may be other similarities among the 32 patients that are different from the majority of people being infected with strepotococci (genetic background? type of infection? co-infection? other health conditions?). Also, at minimum one should add how whether there are gender differences in strep infection. A simple assumption is that those infections may be transmitted by children (as they easily acquire diseases from school). And they may have more contact with mothers than fathers. Of course differences in immune responses may also play a role, but it is important to have sufficient information to estimate the relative contribution.

 

As I said, there is not enough information in the article to form meaningful hypotheses.

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I agree that the rate of occurrence is negligible and that it is more significant to determine why the condition even occurs. Further, I agree that their is insufficient evidence from this article to assert some male immunity as a probable cause of the distinction between males and the occurrence of this condition among females; however, this remains a notable distinction among this small group of individuals who have experienced this obscure illness. What I'm asserting is that what we might find investigating the rare condition could have larger implications worthy of our efforts. It isn't unreasonable to consider that investigating something minor could lead to a major discovery.

Edited by DrmDoc
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I agree, it's more significant to determine causes rather than distinctions if our research goal is prevention. If prevention is our goal, I believe distinguishing factors in occurrence rates could provide clues promoting that effort.

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