House S07EP15 “Bombshells”
Monday evening will come again, and that means the next episode of House! I’m not entirely sure what to make of the Butch and Sundance picture here, but you can’t blame me for that Photoshop. What can we glean from the recap? Well, the title above itself promises big changes in store, but there are still about 7 more episodes in the season until we hit the end of the year cliffhanger. What about the medical case? The synopsis from Fox.com tells us that a teenager with mysterious symptoms which worsen carries a secret that goes deeper than a physical ailment. Meanwhile, Cuddy has to deal with “sobering news that propels her to reevaluate her priorities.” As if none of us have ever had to do that? Still, Cuddy’s issues do promise entertainment for us through some dream sequences, and a musical number! Too bad Glee doesn’t come on right after House.
So let’s recap. We have a plot with a troubled teen, and a medical scare for House’s girlfriend, which start off the same: blood in the urine. We won’t spoil the Cuddy sequence, other than to say it ultimately leads to character growth for both participants, but how about our teen? Turns out that he has a staph infection. The team initially suspected infection due to Staphylococcus aureus, and treated with antibiotics to resolve the symptoms caused by bacteremia. Other symptoms pop up, resulting in a number of relatively invasive diagnostic procedures, which in turn lead us back to the start: a staph infection. The patient in one of his antisocial episodes had been setting off pipe bombs, and ended up being hit by some shrapnel superficially in the abdomen. Many times the body responds to the presence of foreign bodies by walling them off to prevent the spread of infectious agents further into the body. In the case of our patient, an abscess was formed. In an abscess, the walling off can prevent the movement of immune cells, which in turn can prevent proper resolution of the damage by the body. Surgical intervention is generally required.
The most common bacterium associated with abscesses is S. aureus, mainly due to that organism’s prevalence on the human body, and it’s high number of virulence traits. The main symptoms associated with abscesses are pain, redness, fever, and loss of function; all of these were noted by our patient. Antibiotics are generally ineffective at resolving abscesses, for the same reason that the immune system is ineffective at accomplishing this: the walled off structures prevent antibiotics from effectively reaching the site of infection. The standard treatment is typically incision and drainage, following the old medical adage “Ubi pus, ibi evacua,” translated into English (roughly) as “if there’s pus about, let it out.”