<p>This story, from today's Philadelphia Inquirer, is extremely tragic and frightening. A student went to the emergency room (of the Hospital of the University of Pennsylvania, renowned hospital) with meningitis symptoms and was sent home after being told she had a virus and would be fine. A few days later, she died of meningitis, which apparently could have been treated successfully if she had been properly diagnosed. The student did everything she should have done, but the doctors messed up. I can't imagine how heartbroken her parents and family must be.... </p>
<p>Lawyer: Student diagnosis 'wrong'
The Penn sophomore died after being told she had an infection that would clear up.
By Marie McCullough</p>
<p>Inquirer Staff Writer</p>
<p>Anne Ryan and her brother Jed were relieved when an emergency room doctor at the Hospital of the University of Pennsylvania said she had a viral infection that should soon clear up.</p>
<p>The doctor sent Ryan, a 19-year-old sophomore at Penn, home with a form letter certifying that she could go back to classes two days later, on Sept. 8.</p>
<p>Instead, on Sept. 8 she was back in the emergency room, critically ill. She died the next day of meningococcal meningitis, a bacterial infection.</p>
<p>Thomas Kline, a Philadelphia lawyer hired by Ryan's family to investigate what happened, said, "The one thing I can tell you without equivocation is the diagnosis was wrong."</p>
<p>In a statement, Penn officials maintained that Ryan was "cared for in a timely fashion with appropriate medical measures by a dedicated and highly skilled team of health-care professionals."</p>
<p>But the death of the young woman - an Arabic and environmental studies major from Albion, Pa., who had appeared on the cover of the Penn student fashion magazine and in a student fashion show - has raised questions about the appropriateness of her care, the Philadelphia Daily News reported Saturday.</p>
<p>Ryan initially went to the emergency room on Sept. 6 complaining of fever, severe headache, neck pain and nausea. Because these are classic symptoms of meningitis - a rare infection of the fluid in the spinal cord and brain - HUP doctors ordered the standard diagnostic test, an analysis of fluid tapped from the spinal cord.</p>
<p>The hospital's release form shows that just before midnight, she was discharged with an anti-nausea medication and no other treatment. Jed Ryan, a Penn alumnus, took his sister back to his Philadelphia apartment to look after her until she felt up to going back to campus.</p>
<p>"They were relieved," Kline said. "The discharge paper said, 'You have a viral infection. Lumbar puncture results did not reveal any evidence of brain infection.' "</p>
<p>Meningitis can be caused by a viral or bacterial infection. The viral form is usually less severe and goes away without specific treatment, according to the U.S. Centers for Disease Control and Prevention (CDC).</p>
<p>Bacterial meningitis, in contrast, is potentially deadly, and early treatment is crucial.</p>
<p>It "can be treated with a number of effective antibiotics," says the CDC. "It is important, however, that treatment be started early in the course of the disease."</p>
<p>With appropriate antibiotic treatment, the risk of dying is less than 15 percent, the CDC adds.</p>
<p>Tom Clark, a CDC epidemiologist and meningitis expert, said that when bacterial meningitis is suspected, antibiotics are typically started before a final diagnosis is made because rapid diagnostic tests of the spinal fluid are not definitive. Rapid analysis includes counting white blood cells, measuring glucose and protein levels, and staining the fluid to look for bacteria.</p>
<p>The best test, which involves culturing the fluid to try to grow the bacteria, takes about 48 hours, Clark said.</p>
<p>"The usual practice, certainly if you suspect bacterial meningitis, is to treat empirically. Don't wait until the culture results are final," Clark said.</p>
<p>Each year in the United States there are an estimated 2,800 cases of bacterial meningococcal disease, including meningitis, Clark said. The disease is contagious, but is spread only through close, prolonged contact.</p>
<p>Vaccines are available that protect against some types of bacteria that cause meningitis, but these vaccines are not completely protective.</p>
<p>Kline said Ryan had "some meningococcal inoculation," but he did not yet have the specifics. He would not say what type of bacteria caused her meningitis, although an autopsy has identified it.</p>
<p>Following Ryan's death, Penn offered antibiotics to people who had had close contact with her, and created a Web site to educate students about meningococcal disease.</p>
<p>Kline said he was waiting to get the rest of her hospital records. "Penn has promised to cooperate," he said.</p>