Fighting a killer

From the February 4, 2009 edition of The Journal Record
By Stephen Prescott, M.D.

Mariana Bridi da Costa was the picture of health – a vibrant, 20-year-old Brazilian model. But last month, less than a week after she contracted a urinary tract infection, she died, her young body ravaged by a routine illness that morphed into something much, much worse.

That something was a little-known but deadly and surprisingly common condition known as sepsis.

Sepsis typically starts out as an isolated infection – perhaps a skin wound or, as with Muppets creator Jim Henson (killed by sepsis at age 53,) it began with pneumonia, an inflammation of the lungs.

Usually, our bodies can fight these infections. In sepsis, though, the infection moves into the bloodstream.

The body responds by calling in an overwhelming counterattack. But this response often proves more devastating than the infection itself, causing fever, breathing difficulties, confusion and, ultimately, tissue death and multiple organ failure. In the U.S. alone, 250,000 people die each year from sepsis.

Perhaps most frightening is the swiftness with which sepsis moves, killing in a few days – or even hours. Doctors have an ominous saying about the illness: “Fine in the morning, dead in the evening.”

Like so many sepsis cases, Mariana’s story ended tragically. But maybe it didn’t have to.

In 2001, after the failure of more than 20 experimental drugs to treat sepsis, the Food and Drug Administration approved a new medication to treat severe sepsis. That drug, Xigris, has its roots in the work of two Oklahoma Medical Research Foundation scientists, Charles Esmon and Fletcher Taylor.

Esmon and Taylor discovered a method of controlling the body’s blood-clotting cascade. This work led to Xigris, which reduced mortality among the most severe sepsis patients by 24 percent.

At OMRF, we’ve been lucky enough to meet two people saved by Xigris: Jeanne Morgan, a clinical psychologist from Oklahoma City, and Rayna DuBose, a 19-year-old basketball star at Virginia Tech who faced a life-threatening bout with sepsis.

While Jeanne’s story has an unqualified happy ending, Rayna’s is more complicated. Although Xigris saved her life, it could not reverse the loss of circulation that had mummified Rayna’s extremities, and surgeons were forced to amputate her hands and feet.

But that is not the end of Rayna’s story. She was fitted for prosthetics and returned to school, where she served as a student assistant coach and earned her degree. She now lives independently and has begun a motivational speaking career.

When Rayna visited OMRF last year, she said that if she had a life “do-over,” she wouldn’t change a thing. Her brush with death taught her to value life and led her to her true calling – motivating those facing obstacles that appear insurmountable.

Could Xigris have saved Mariana Bridi da Costa? We will never know. But I promise that she, like Rayna DuBose and Jeanne Morgan, would have jumped at the chance to find out.

Stephen Prescott is president of the Oklahoma Medical Research Foundation. E-mail: OMRF-President@omrf.org.

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