Raffaella Bianucci1,2,3, Otto Appenzeller4,5, Peter Evans6, Philippe Charlier7,8, Antonio Perciaccante9. 1. Legal Medicine Section, Department of Public Health and Paediatric Sciences, University of Turin, C.so Galileo Galilei 22, 10126, Turin, Italy. raffaella.bianucci@unito.it. 2. Warwick Medical School, Microbiology and Infection Division, University of Warwick, Coventry, UK. raffaella.bianucci@unito.it. 3. UMR 7268, Laboratoire d'Anthropologie bio-culturelle, Droit, Etique and Santé (Adés), Faculté de Médecine de Marseille, Marseille, France. raffaella.bianucci@unito.it. 4. New Mexico Health Enhancement and Marathon Clinics Research Foundation, 361 Big Horn Ridge Dr. NE, Albuquerque, NM, USA. 5. New Mexico Museum of Natural History and Science, 1801 Mountain Road NW, Albuquerque, NM, USA. 6. , Unit 1, 26 Windsor Cres Surrey Hills, Melbourne, VIC, 3127, Australia. 7. Section of Medical and Forensic Anthropology (UVSQ DANTE Laboratory EA4498), 2 avenue de la Source de la Bièvre, 78180, Montigny-Le-Bretonneux, France. 8. CASH and IPES, 403 avenue de la République, 92000, Nanterre, France. 9. Department of Medicine, "San Giovanni di Dio" Hospital, Gorizia, Italy.
Abstract
PURPOSE: St. John of the Cross (1542-1591) died aged 49 years after 3 months of excruciating pain following a trivial lesion in his right foot. Erysipelas, a superficial bacterial infection of the skin, and subsequent sepsis were previously suggested as the cause of his death. Here, an alternative diagnosis is proposed. METHODS: An accurate perusal of his biography allowed the symptomatology, the clinical evolution, the depth of the infection and the associated systemic manifestations displayed by Fray John to be reconstructed. RESULTS: St. John of the Cross developed cellulitis in the foot, which turned into a cutaneous abscess. To treat the toxaemia and inhibit further necrosis of the skin, excision of necrotic tissue and cauterization of the sores were performed to no avail. The infection burrowed through the fascial planes and reached the bones of the leg, leading to osteomyelitis. CONCLUSIONS: In the absence of antibiotic treatments and proper antiseptic procedures, the soft-tissue infection spread deeper to the bones. It is not unconceivable that the surgery might have further promoted the spread of the bacteria giving rise to the secondary sepsis that led to St. John's premature death.
PURPOSE: St. John of the Cross (1542-1591) died aged 49 years after 3 months of excruciating pain following a trivial lesion in his right foot. Erysipelas, a superficial bacterial infection of the skin, and subsequent sepsis were previously suggested as the cause of his death. Here, an alternative diagnosis is proposed. METHODS: An accurate perusal of his biography allowed the symptomatology, the clinical evolution, the depth of the infection and the associated systemic manifestations displayed by Fray John to be reconstructed. RESULTS: St. John of the Cross developed cellulitis in the foot, which turned into a cutaneous abscess. To treat the toxaemia and inhibit further necrosis of the skin, excision of necrotic tissue and cauterization of the sores were performed to no avail. The infection burrowed through the fascial planes and reached the bones of the leg, leading to osteomyelitis. CONCLUSIONS: In the absence of antibiotic treatments and proper antiseptic procedures, the soft-tissue infection spread deeper to the bones. It is not unconceivable that the surgery might have further promoted the spread of the bacteria giving rise to the secondary sepsis that led to St. John's premature death.
Authors: Dennis L Stevens; Alan L Bisno; Henry F Chambers; E Patchen Dellinger; Ellie J C Goldstein; Sherwood L Gorbach; Jan V Hirschmann; Sheldon L Kaplan; Jose G Montoya; James C Wade Journal: Clin Infect Dis Date: 2014-07-15 Impact factor: 9.079