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When A Patient Presents

Updated on July 18, 2012

Microbial Disease For Effect

It is not an infrequent thing to use aspects of medical microbiology for effect in horror films. Several come to mind for me; but the one I like most is Amityville Horror II. In that movie the symptoms of Francisella Tularensis (a/k/a “F. Tularemia) make their appearance in a young boy, exaggerated only slightly. Panning the camera in on the glands of the boy’s neck, to accentuate the appearance of something “moving” underneath the skin is true to sensation if one is consumed with this disease.

Also true to form and characteristic of this disease is the dramatic change in mental status that consumes the boy to such degree he becomes insane and kills his entire family.

As the movie depicts it though, one is liable to think the disease “moves” under the skin, or is “motile,” when in actuality the infection only feels like it is moving. That is because it attacks virtually every gland in the body. F. Tularemia is as a gram-negative, intracellular and non-motile, coccobacillus.

F. Tularemia produces a “glandular” fever in both animals and humans. Discovered by a man named Edward Francis, F. Tularemia was first seen in Tulare County, California (don’t have the year). F. Tularemia can live in a person’s body for a long time. Like E. coli, this organism – transmitted by animals and through contaminated water – has a similar endotoxin, even though it is considerably less active than endotoxins found in other gram-negative bacilli like E. Coli, which basically means there will be a long stretch of time before it becomes fatal.

Human tularemia is acquired most often by the bite of an infected animal or arthropod, or contact with an animal that has caught an infected animal. The disease is most common in Arkansas, Missouri and Oklahoma. Most of the infections occur in the summer. If transmitted in winter, it is usually among hunters of rabbit that most cases will make their appearance. [They say that if a rabbit is moving “slowly” the rabbit could be infected.]

The disease can affect any organ system in the body and usually presents as flu after a 3-5 day incubation period with fever, chills, malaise and fatigue. Patients with the glandular form of this disease, like in the movie Amityville Horror II, suffer identical symptoms to that of a typhoid-like fever and usually present with a chronic and low-grade systemic “sepsis.” The glandular form of this disease is the most difficult to diagnose and is associated with the highest mortality rate. There are only about 100 cases diagnosed a year in the United States; but the actual number of infections is said to be much higher because this disease is frequently not suspected and difficult to confirm by laboratory tests.

Although not immediately fatal, like say E. coli for example, the illness is “all-consuming” and anyone with it is likely to go mad from the pain it inflicts on the internal organ system. As the young boy in Amityville Horror II portrays true to form, it will make any human saturated with this disease appear “demonically possessed” even when they are not. That is because the pain of it is equivalent to first degree burns covering the body on the inside. Since outward symptoms are not available to a most discerning eye, one would be inclined to believe that the person suffering from this disease is “psychotic,” and, in truth, a person may very well become that way when the disease goes undetected.

So I wrote this hub as an example of one of many diseases that may go undetected with great consequences, and wish to mention another, Taenia Solium, that when left undiagnosed produces psychosis also, and which is rarely diagnosed in the United States. If you want to know the name of yet another great horror movie that uses aspects of disease for effect, check out the X-Files and take notice of what takes over a boy in a ditch in Texas when the movie opens its first scene. Hint: I already mentioned the name of it in this hub.


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