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When Pneumonia Kills Healthy Adults

26 December, 2019 by GAggreyMD Leave a Comment

Christmas Eve this year brought news of ESPN reporter, Ed Aschoff, dying that day, also his 34th birthday, after being treated for pneumonia. I did not know of him, but soon I was reading his Twitter profile. Earlier in the month he had shared the following:

Anyone ever had multifocal (bilateral) pneumonia in their early 30s as some who never gets sick and has a very good immune system? Asking for two friends … my lungs.

— Edward Aschoff (@AschoffESPN) December 5, 2019

It’s hauntingly sad to read that now. I can imagine that his family, friends, and loved ones are at a loss. I will admit I, an infectious disease physician, scratched my head, reading article after article for a risk factor to explain his untimely death.

Pneumonia is an infection in which the alveoli (air sacs) in the lungs get inflamed and can fill up with pus or fluid making it difficult to breathe. Any microbe (bacteria, virus, fungi) can cause pneumonia. Symptoms can be mild or severe and can present as what we colloquially call “flu-like illness”.

Truth is that anyone can get pneumonia but there are some people who are more susceptible than others. These would include older people (where old is age greater than 65), the very young, people with lung disease like asthma, COPD, bronchiectasis, people with heart disease like congestive heart failure, people who are immunocompromised, diabetics, and smokers to name a few.

In addition, influenza can lead to pneumonia. This is why we encourage the influenza vaccine so much, even with its shortcomings. Sometimes it is the influenza virus itself causing a viral pneumonia. Worse is when having influenza puts you at risk for bacterial pneumonia. We are having a busy influenza season so far this year. I’ve seen my fair share of otherwise young and healthy people end up in the hospital. Still nowhere near the H1N1 epidemic of 2009 though.

The CDC says that more than 250,000 people are hospitalised annually in the US with pneumonia and about 50,000 die. Pneumonia is serious. Even I need a reminder. I take care of patients with pneumonia on a daily basis and the vast majority do very well.

What is perplexing is why an otherwise healthy young adult would die despite treatment. Unfortunately, this happens more often than one would expect. Sometimes when a healthy body triggers a sepsis cascade in response to an infection, that response is just too overwhelming. There’s no rhyme or reason. I’ve seen frail, elderly people with poor immune system survive what would otherwise be a devastating infection because their immune system was too weak to trigger the appropriate cascade. And then the healthy young in the next room crashes on full support.

Reading the Twitter feed of Edward Aschoff this Christmas season is too sad. It’s obvious he is beloved. May he rest in peace and may his family find comfort in these hard times.

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Filed Under: Infectious Diseases Tagged With: Antimicrobials, Death, Influenza, Pneumonia, Sepsis, Social Commentary, Social Media, Streptococcus, Vaccines

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