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efreysson
03-14-2010, 11:44 AM
I have a character who gets a deep, nasty cut on the thigh, and doesn't receive proper medical care until several days later. I need him to get a deadly infection, which he KNOWS is going to kill him. The idea is that, knowing he is screwed, the guy resorts to extreme measures to get revenge.

This is a medieval-esque fantasy, and our modern medicine isn't going to bail him out of this one, so I really just need to know how fast this kind of infection kills, what the symptoms are, and how long the victim might stay conscious.

Al Ross
03-14-2010, 11:53 AM
Make the infection inflicted magical. You know the classic poisonous arrow in the hart. Or just plain touched by Death. A curse sword/knife cut him.

A deadly infection give you the shivers, high temperature. I once stepped, bare feet, on a cactus. After a few hour I was flat on bed for a day with a fever. I guess a more deadly infection might do worst. So the mc must be a very strong man. (or woman)

efreysson
03-14-2010, 11:56 AM
Make the infection inflicted magical. You know the classic poisonous arrow in the hart. Or just plain touched by Death. A curse sword/knife cut him.

A deadly infection give you the shivers, high temperature. I once stepped, bare feet, on a cactus. After a few hour I was flat on bed for a day with a fever. I guess a more deadly infection might do worst. So the mc must be a very strong man. (or woman)

It's not the mc, it's a villain, slashed by the hero. And it's just an ordinary blade, no magic or poison.

Shakesbear
03-14-2010, 12:56 PM
Tetanus? I've no idea how long it takes to kill someone though. IIRC swords and arrows were often stuck into soil before use as that would increase the chances of infection.

shaldna
03-14-2010, 03:09 PM
In this case you'd be lookint at tetanus, gangreen or septicemia.

And none of these options are good. I had septi once and I was unconsious for a week within hours of it developing.

When an infection is adncanced enough to potnatilly cause death then you'd not going to be able to move, let alone think straight, and your entire phycial being becomes useless. I didn't have enough strength to sit up on my own for weeks afterward

PeterL
03-14-2010, 05:48 PM
Too bad it's his thigh. Blood poisoning that started on his foot would give him more of an opportunity to watch the infection travel up his leg. Eventually it would get to his brain and kill him. It could be cured in the early stages by swaoking in very hot water.

Fenika
03-14-2010, 07:05 PM
Go for rabies :e2teeth:

Otherwise, what they said.

And tetanus takes 1-3 weeks to incubate before you start getting stiff. Soon after that you are in the classic on your back and stiff as hell position and good luck to you and try not to scream b/c you're in intense farking pain.

efreysson
03-14-2010, 07:44 PM
Too bad it's his thigh. Blood poisoning that started on his foot would give him more of an opportunity to watch the infection travel up his leg. Eventually it would get to his brain and kill him. It could be cured in the early stages by swaoking in very hot water.

Well, I COULD make it the lower leg. How long would it take to travel up, and what would it look like? He's in the wilderness, so he doesn't have the option of cleaning the wound properly.

cscarlet
03-14-2010, 07:49 PM
Septicemia can take a bit to occur (though once it does it hits you like a ton of bricks). Your villain could suspect what will happen not long after (depth of cut and if it got dirty), and then he will "know" what will happen if - despite care - it gets infected. It would be pretty bad though at that point (it will hurt beyond belief, stink to high heaven, etc.). Then once it's infected, the infection will eventually spread to the bloodstream.

Gangrene is also a good suggestion... To stop the spread you have to cut the limb off. Otherwise you're stuck. That's why when people with diabetes get gangrene in their... err.... lower torso area.... it's so bad (and really, really gross).

shadowwalker
03-14-2010, 08:10 PM
I used septicemia in a story - it worked well, because it was a slow enough spread that I could keep the story going a while, but serious enough that it kept people worried as to whether he (the good guy) would make it.

SWest
03-14-2010, 08:26 PM
I had Staph attack a second-degree sunburn once (shins)...the fever developed pretty quickly (two days?), and within five days my kidneys had failed. Throughout the entire two weeks that I was being treated, I had virtually no short-term memory working. Basically, you just lie quietly while you are eaten to death.

Although my early experience of Pain was minimal, so was my ability to function on anything but a rudimentary level (eat, wash, let dogs out, feed dogs, pass out, come to on the floor, go to bed).

An untreated open gash would progress to delirium pretty quickly, so without "magical assistance" there would be no believable way for someone to plan a revenge on their own. Gothic romances use these kinds of wounds a lot to set couples up to fall for each other---the tough guy gets gashed in battle and lies helplessly in a fever while the girl nurses him under a doctor's supervision.

If the cut breaks the skin in any way, circulatory access is established...in fact, pathogenic bacteria culture quite nicely in the lower limbs because they are below the heart. The body is less able to cope with cellulitis (inflammation of the skin) when gravity is preventing free-circulation of blood and lymph.

The medical issues to research found here (http://www.webmd.com/skin-problems-and-treatments/staph-infection-cellulitis).

Tetanus does buy you more time, but goes somewhat unnoticed until paralysis occurs. Even if your character pool were familiar with this infection, there in no way to predict the course of disease, so again no way to know how a revenge plan might proceed (unless the villain does not care if his plot unfolds in his absence).

Toxicity to the liver or kidneys via ingested or injected plant residue may be more plausible (a la Crouching Tiger, Hidden Dragon).

Acute renal failure would certainly result in a fatality where no intensive medical support is available (i.e., any non-modern times). Although extremely painful and accompanied by other gory symptoms, a person may remain functional and able to recruit help executing a revenge scheme (as long as the plant was not also immediately neurotoxic).

For example, see here (http://grande.nal.usda.gov/ibids/index.php?mode2=detail&origin=ibids_references&therow=273517).

Fenika
03-14-2010, 08:31 PM
Don't confuse Tetanus with Botulism btw. Spasmic rigidity vs flaccid paralysis.

Otherwise, what they said (again). :)

SWest
03-14-2010, 08:47 PM
Don't confuse Tetanus with Botulism btw. Spasmic rigidity vs flaccid paralysis.

Otherwise, what they said (again). :)

The rigidity caused by Clostridium tetani is called paralysis...whenever you lose willful control of your body you are paralyzed. But yes, the way that the disease manifests through the nerves and muscles is important to creating a plausible story.


This is a medieval-esque fantasy, and our modern medicine isn't going to bail him out of this one, so I really just need to know how fast this kind of infection kills, what the symptoms are, and how long the victim might stay conscious.


The folks in non-fict might be able to help you put together some interview questions. Sit-downs with infectious disease specialists and/or nephrologists would probably be very useful.

shaldna
03-15-2010, 02:34 AM
Too bad it's his thigh. Blood poisoning that started on his foot would give him more of an opportunity to watch the infection travel up his leg. Eventually it would get to his brain and kill him. It could be cured in the early stages by swaoking in very hot water.


blood poisoning spreads in about 40 minutes.

A tissue infection would spread more slowly, which is what I think you are thinking off.

shaldna
03-15-2010, 02:35 AM
Go for rabies :e2teeth:

Otherwise, what they said.

And tetanus takes 1-3 weeks to incubate before you start getting stiff. Soon after that you are in the classic on your back and stiff as hell position and good luck to you and try not to scream b/c you're in intense farking pain.


an infected tetanus wound can kill you in a matter of days.

PeterL
03-15-2010, 04:41 PM
Well, I COULD make it the lower leg. How long would it take to travel up, and what would it look like? He's in the wilderness, so he doesn't have the option of cleaning the wound properly.

To travel up it could take a few days to more than a week. It would look like a red line on the surface, starting as an inflamed spot where the infection started. It could be treated easily with antibiotics, but without anythere isn't much except soaking in hot water.

Shakesbear
03-15-2010, 09:52 PM
Does it have to be a real infection? Couldn't you make something up that suits the needs of the plot?

Tsu Dho Nimh
03-15-2010, 10:24 PM
What would it look like:
Swollen, red, oozing stinking yellow or greenish pus, with red streaks on his skin running up towards his body ... may or may not be painful, but he would recognize the signs and know he would be unlikely to live.

efreysson
03-16-2010, 01:43 AM
What would it look like:
Swollen, red, oozing stinking yellow or greenish pus, with red streaks on his skin running up towards his body ... may or may not be painful, but he would recognize the signs and know he would be unlikely to live.

Okay. But what other symptoms are there? Sweating? Fever? Shaking? Vomiting? How noticeable is the pus smell?

Linda Adams
03-16-2010, 04:46 AM
The infection may also not necessarily take a few days--it could move very quickly. I got an infection from trimming a hangnail. My finger swelled up so much it felt like it was going to burst. Then it start streaking (that was the term the hospital used), which was a line of red starting at the point of the infection and moving up. All of this within a couple of hours.

Silver King
03-16-2010, 05:10 AM
The infection may also not necessarily take a few days--it could move very quickly. I got an infection from trimming a hangnail. My finger swelled up so much it felt like it was going to burst. Then it start streaking (that was the term the hospital used), which was a line of red starting at the point of the infection and moving up. All of this within a couple of hours.
That streaking follows a vein to the closest lymph node. It happened to me when I had blood poising from a wound on my left hand. The lymph node under my arm began to swell and became very sore. I was told that had I not sought treatment that night (I almost fell asleep), that I would not have lived to see the sun rise the following morning.

efreysson
03-16-2010, 10:35 AM
The infection may also not necessarily take a few days--it could move very quickly. I got an infection from trimming a hangnail. My finger swelled up so much it felt like it was going to burst. Then it start streaking (that was the term the hospital used), which was a line of red starting at the point of the infection and moving up. All of this within a couple of hours.

From trimming a hangnail? That's . . . pretty disquieting.

But anyway, unless I do some rewrites I'll need the guy to stay alive for a few days.

RobinGBrown
03-16-2010, 12:09 PM
Watch this

http://www.imdb.com/title/tt0479884/

and this

http://www.imdb.com/title/tt1121931/

for inspiration.

Tsu Dho Nimh
03-16-2010, 09:20 PM
Okay. But what other symptoms are there? Sweating? Fever? Shaking? Vomiting? How noticeable is the pus smell?

Fever can be from slight to severe, usually increasing over time, with a "hot spot" around the wound and getting larger, spreading upward.
Pain likewise, but increasing and spreading up the leg.
Shivering and shaking ... increases with fever.
Steadily increasing symptoms :)

The pus may or may not have a smell ... some bacteria known to cause eventual septicemia and death stink, others are almost odorless, with the common 'sweet' smell of some of the Pseudomonas meaning a really nasty outcome.

Make it as stinky as you want, perhaps with a well-known smell like the ____ (fantasy culture reference here, maybe is smells of a certain flower or unicorn poop) ___ that presages a death wound that not even the ___ can cure.

The red streaks are the infection creeping up the lymph channels, being fought by white blood cells. If they hit the groin area they can escape the lymph system into the bloodstream and turn into septicemia ("blood poisoning") which is bacteria in the blood stream ... from there to death can be a few hours to days of severe prostration and high fever with all the shaking and sweating and delirium you can use.

Typically a slowly increasing infection that turns into a sudden collapse

shaldna
03-17-2010, 02:20 PM
I have to say, having has septi, that's it's not a good way to go.

Within about three hours of me being admitted to hospital my fever hit 116 and the hospital called my parents telling them that if they wanted to see me then they had to come now.

The doctor said afterwards that he had never seen anyone with a fever that high live before and that I was very, very lucky to not only be alive, but to not have suffered severe brain damage as a result,

My point is this, often it's not the actual injury that does you damage, or the infection, but the other factors that the infection causes, such as afever etc.

GeorgeK
03-17-2010, 07:58 PM
Okay. But what other symptoms are there? Sweating? Fever? Shaking? Vomiting? How noticeable is the pus smell?

Not much really because if the pus can drain out, then your body has walled it off and you might heal. Septic patients need to have the pus drained. There is a saying in surgery, "The sun must never set on pus!" Most septic patients that I've seen were too sick to have rigors or "shake". It takes a lot of energy to shiver. By the time they're in the hospital they just lay there. I've taken care of hundreds to thousands (ok, probably not thousands, but certainly hundreds) of septic patients and have been septic once. It gives you the most amazing sense of apathy. When the patient stops complaining is when you worry.

There is a look and smell of the septic patient but even most physicians have trouble recognizing it and I'm not sure how to describe it. They tend to have a false bravado. Often you can see veins in their faces. They often are flushed. They smell...sick...slightly fishy and sour.

You have about a day between when you realize you are shi# out of luck and when you crash. Most people at that point have 3-5 days of delirium and illness induced bedrest before they die if left untreated.