About Shigella

Presented By Marler Clark The nation’s leading law firm representing victims of Shigella and other foodborne illness outbreaks.

Real Life Impacts: The Story of Maryann

At the time she became ill with a Shigella infection, ‘Maryann’ was 56 years old and lived with her daughter. She was working in housekeeping at a hospital.

Maryann became ill on Saturday morning, February 27, 2010.  Her initial symptoms included stomach cramps and diarrhea, but soon progressed to include headache and fatigue as well.  She had numerous bouts of diarrhea that morning, and her stools soon became watery.  She tried to drink fluids but had difficulty swallowing.  She spent the rest of the day either in bed or in the bathroom.

Sunday brought no relief.  The cramps were occurring almost non-stop, and the diarrhea burned as it exited her body.  It felt as though “shards of glass” were tearing through her intestines.  She estimates that she was having a bout of diarrhea at least every half-hour.  Her head was also throbbing and she felt dehydrated.  She had been unable to sleep at all the previous night and was fatigued.  As the day wore on, Maryann began to have difficulty standing.

On Monday, March 1, Maryann could barely make it out of bed to reach the bathroom.  Each time she tried to stand, sharp pains would shoot through her abdomen.  Making her way to the toilet became so unbearable that she started wearing diapers instead.

After another sleepless night, by Tuesday morning Maryann could no longer handle the abdominal pain and diarrhea.  By this point she was also extremely dehydrated and her voice was dry and crackly.  She asked her daughter to drive her to the ER.

When Maryann arrived at the ER, she had to be taken inside by wheelchair because she did not have the energy or ability to walk.  She was in such horrible pain from the cramps that she was grasping her stomach and doubled over.  Maryann was lifted onto a gurney and was immediately started on IV fluids.  Blood samples were also drawn. Maryann’s abdomen was distended and there were bowel sounds throughout.  Pain medications were administered to combat her painful symptoms, then Maryann was admitted for further testing, fluid hydration, and pain management.  Maryann was also asked to provide a stool sample.

Once admitted, it was noted that Maryann had a low potassium level of 2.6 and that she was obviously dehydrated.  Moreover, while the fluid rehydration helped resolve her diarrhea some, she did not fully improve.  Maryann’s doctor believed that her problem could be viral or bacterial, and that they would have to wait for stool culture results to determine the cause of her illness.

The following day, Wednesday, March 3, Maryann’s blood work showed rising leukocytosis, a decreasing red blood cell count, low potassium, high creatinine, and abnormal liver enzymes.  Her stool studies showed a moderate volume of white blood cells and were negative for Clostridium difficile.  Doctors believed that her acute diarrhea and abdominal pain might be related to an infectious syndrome, possibly food poisoning.  A liver ultrasound was performed to evaluate her abdominal pain and liver function.  The ultrasound revealed the appearance of a cirrhotic liver.

Maryann suffered abdominal pain, nausea, vomiting, and diarrhea all day long.  She remained on IV fluids and medication to manage the discomfort of her painful symptoms. 

The next day, Thursday, March 4, Maryann remained on IV fluids with pain medication.  The medication would help ease the cramping a little, but she still cringed each time she was beset by another cramp.  Her heart beat was rapid and she was very weak.  Maryann was able to make it to the bathroom, sometimes, but only by stabilizing herself on the IV pole.

Throughout the weekend, Maryann’s condition did not improve. She was still in pain, having frequent bouts of diarrhea, and hooked up to an IV.  She was unable to get out of the bed on her own and had to have assistance using the bathroom.  On many occasions she was not able to make it there in time.  Maryann learned that weekend that her stool culture tested positive for Shigella.

Maryann continued to suffer from nausea, vomiting, and severe abdominal cramps the next day, March 8.  Further, she stated, “I felt like my throat was burning.” That morning she was given three units of fresh frozen plasma because she was scheduled to undergo a therapeutic ultrasound guided paracentesis.  Maryann was suffering such extreme fatigue that she could not even sit up.  Her blood pressure was low, and blood tests showed that her red blood cell count was also low.  Her doctors scheduled her to receive a blood transfusion.  Later that evening a CT scan of her abdomen and pelvis that showed interval development of a moderate amount of abdominal fluid.  There was also diffuse infiltration of subcutaneous fat of abdomen and pelvis, which suggested widespread swelling.  She was then returned to her room where she was started back on IV fluids.

On March 9, a dietitian checked in on Maryann and reported that she was lacking in nutrient intake and was at moderate nutritional risk.  Maryann was also still in pain and the diarrhea continued. The frequency of stomach cramps had decreased a little, but her abdomen was still distended.  She was also unable to walk without assistance and was generally very weak. 

Maryann showed a few signs that her condition might be worsening the following day. Her blood pressure had dropped even further, and a blood test showed that her red blood cell level was lower.  This prompted her doctors to recommend another blood transfusion, which she received later that evening.  This helped to stabilize her blood pressure and Maryann felt considerably better.

On March 11, Maryann wanted to leave the hospital to continue recovering at home, but her doctors recommended that she instead be transferred to a skilled nursing facility.  Though Maryann resisted at first, she reluctantly agreed at the urging of her family and doctors.  At this time Maryann still had fluid build-up, was having trouble with any oral intake, and she could barely walk.  Around this time a priest came by her room to pray for her healing.  Maryann was told that she could be transferred the following morning.

Friday morning, March 12, Maryann was disconnected from her IV and was prepared for discharge.  She was told that she would need to adhere to a low sodium diet and drink plenty of fluids.  Her doctors also advised her that she was at high risk of falling and that she would need to use a wheelchair.  She was also told that she would have to go through physical therapy at the nursing facility to regain the use of her legs.

Maryann was transferred to the ManorCare Health Services later that day. Upon admission, she was suffering severe abdominal pain, and abdominal distention.  Though Maryann was happy to be out of the hospital, she had a long road to recovery ahead of her. She states:

At the nursing home I still had to have total assistance.  I’m an outdoor person and just to get some fresh air I had to wait until an aide, my sister, or daughter could come and take me out.  I also had to go through very painful physical therapy until my strength was built up enough where I could get myself into and out of the wheelchair.  It was very painful trying to do exercise I didn’t have the strength to do.

She was scheduled for physical therapy sessions, six days a week, for 60 days.  Moreover, her fragile condition required constant supervision so she had to remain at ManorCare for over a week.  During this time, Maryann continued to suffer from a number of ailments.  She was having frequent bouts of diarrhea.  Her abdomen was also distended for quite some time and she required multiple treatments to drain the fluid.  She was not tolerating food or liquids well, which added to her weakness and fatigue.  She remained on pain medication the duration of her stay.  Even when she was eventually discharged on March 20, Maryann was still unable to make it to the bathroom without holding on to something, or someone.

When Maryann returned home she was confined to a wheelchair, walker, or cane for several months. She could not even make it up the stairs of her own house, so she had to sleep on a couch in her living room. Whenever she left the house, even just to go grocery shopping, Maryann had to use a wheelchair.

To this day Maryann has not completely recovered.  Her acute symptoms of abdominal cramps and diarrhea have subsided, but she is still very weak and has difficulty with any moderately strenuous activity. 

Maryann’s medical bills related to her Shigella infection exceeded $60,000.