Lethal infection

efreysson · Feb 2, 2008

An important scene in my book has a character dying slowly from mistreatment and injuries. I need her to be unmistakably dying, yet able to deliver a final speech, and ask to be put out of her misery. Can someone give me the basics on infections in open wounds, both what they do and what they look like?

Finni · Feb 2, 2008

Look into MRSA. Do a google search and read as much as you understand. If you need any help after this ask.

If someone isn't being treated properly and they have a wound this would be a HUGE concern.

ColoradoGuy · Feb 2, 2008

I think the symptoms your character would most likely have when dying of an infection from an infected wound (sepsis) would be these:

1. Pain from the wound.
2. Altered level of consciousness from fever and shock
3. Possibly shortness of breath (and resultant difficulty speaking) from effects on the lungs of sepsis
4. Overall weakness

Reliable old descriptions of this situation in the medical literature (such as typhoid fever) show people could come and go in their delirium, with lucid times (often when the fever came down) alternating with delirium and hallucinations. Over time the lucid spells decrease, the person becomes comatose, their breathing and heart beat more irregular, and then dies. There is a lot of individual variation in all situations like this, even today, so in general you can do as your plot requires.

ColoradoGuy · Feb 2, 2008

Finni said:
Look into MRSA. Do a google search and read as much as you understand. If you need any help after this ask.

If someone isn't being treated properly and they have a wound this would be a HUGE concern.

MRSA (Methacillin Resistant Staphylococcus Aureus) does not have any symptoms particular to it. It is just a staphylocccal infection that is especially difficult to treat because of the antibiotic resistance pattern of the bacteria.

HeronW · Feb 2, 2008

Your MC could be afflicted by flesh-eating bacteria--a fairly new disease, a variant just out does not respond to any of the powerful drugs. Pictures are priceless...

http://images.google.com/images?q=f...t:en-US&um=1&ie=UTF-8&sa=X&oi=images&ct=title

ColoradoGuy · Feb 2, 2008

You asked what an unattended wound might look like: dark red to purplish to black in color around the actual wound, a good deal of swelling of the area (or of the whole limb if an arm or a leg), drainage of greenish to whitish pus from the wound. Much of the pain is from the pressure of swelling in the tissue, so the pain becomes less when the tissues rupture and drain pus. Lovely. It was to prevent all this, of course, that standard treatment of a limb with such a wound was to amputate it. It the infection had spread beyond the immediate area, it was too late to prevent death of the patient, whose symptoms would be like those I noted above.

job · Feb 2, 2008

efreysson said:
An important scene in my book has a character dying slowly from mistreatment and injuries. I need her to be unmistakably dying, yet able to deliver a final speech, and ask to be put out of her misery. Can someone give me the basics on infections in open wounds, both what they do and what they look like?

The problem is ...
Dying of infection would be more like your gal hurting and drifting in and out of consciousness, hour after hour after hour, gradually getting more and more feverish and vague and confused till she can't be brought back to consciousness again.
You don't get that sort of sharp clean break between thinking and talking and then, gack urk twitch, dying.
Infection isn't so good for 'final speech' -ness.

Now you could have a patient under sedation for pain from the injury, and the doctor witholds pain medication long enough for the patient to become lucid if they had to say something. Then, when the necessary words were said, the doctor could put them under again.
That might give you the setup you need.

The 'unmistakably dying' part gets iffy. Mostly, if the patient is still up and talking there's a good chance they're going to make it. There's always a new antibiotic to try. 'Unmistakable' tends to comes into play when the patient is in much worse shape.

If you want infection, rather than death by organ failure, consider belly wounds or a Central Nervous System infection.

Have you considered burns?

Horseshoes · Feb 2, 2008

What's the setting? Modern hospital? Historical? Mediocre contemporary med clinic?

efreysson · Feb 3, 2008

ColoradoGuy said:
You asked what an unattended wound might look like: dark red to purplish to black in color around the actual wound, a good deal of swelling of the area (or of the whole limb if an arm or a leg), drainage of greenish to whitish pus from the wound. Much of the pain is from the pressure of swelling in the tissue, so the pain becomes less when the tissues rupture and drain pus. Lovely. It was to prevent all this, of course, that standard treatment of a limb with such a wound was to amputate it. It the infection had spread beyond the immediate area, it was too late to prevent death of the patient, whose symptoms would be like those I noted above.

Ah, thanks. Could you tell me how long it takes from the wound being inflicted to an infection getting to that stage, in unsanitary conditions?

job said:
The problem is ...
Dying of infection would be more like your gal hurting and drifting in and out of consciousness, hour after hour after hour, gradually getting more and more feverish and vague and confused till she can't be brought back to consciousness again.
You don't get that sort of sharp clean break between thinking and talking and then, gack urk twitch, dying.
Infection isn't so good for 'final speech' -ness
...
The 'unmistakably dying' part gets iffy. Mostly, if the patient is still up and talking there's a good chance they're going to make it. There's always a new antibiotic to try. 'Unmistakable' tends to comes into play when the patient is in much worse shape.

Well, I guess I should have mentioned that my story is a low fantasy. There are no antibiotics to fight an advanced infection. And I didn't mean that she dies instantly upon finishing her speech. She finishes her speech, and then asks to be euthanised so she doesn't have to go the slow way.

Dragon-lady · Feb 3, 2008

There are several non-fiction accounts of mountain and rock climbers and such injured and dealing with wounds without medical care (some are a bit horrific, be warned). They might give you a good idea of how this would be since untreated wounds are fairly uncommon under most circumstances these days. There are also should be some historic accounts--civil war hospitals and so forth.

ColoradoGuy · Feb 3, 2008

efreysson said:
Ah, thanks. Could you tell me how long it takes from the wound being inflicted to an infection getting to that stage, in unsanitary conditions.

You can really do as your plot requires because the time would depend upon how heavy the initial inoculum of bacteria was: e.g, a big slice with a dirty object would be badly infected within a day, a smaller slice with a cleaner object could take several days, and any wound that involved a normally contaminated body cavity like the intestines would be badly infected within a day or so. There is also variability among people. If you use the ballpark example of contaminated battle wounds from the Civil War era, death was usually within several days to a week. There are famous examples, such as Stonewall Jackson's death, which I believe took several days after his initial wound. You could Google his story to get an idea. His death was observed by several people who recorded their experience later and you might find their descriptions useful. He had a moment of lucidity at the end, as I recall.

Lethal infection

efreysson

Closer than ever

Finni

discipula vitae

ColoradoGuy

I've seen worse.

ColoradoGuy

I've seen worse.

HeronW

Down Under Fan

ColoradoGuy

I've seen worse.

job

In the end, it's just you and the manuscript

Horseshoes

lisapreston.com

efreysson

Closer than ever

Dragon-lady

ColoradoGuy

I've seen worse.