APPENDIX A
Statement by Scott Wade, M.D.As an infectious diseases specialist I was asked to see Dr. Eben
Alexander when he presented to the hospital on November 10, 2008, and
was found to have bacterial meningitis. Dr. Alexander had become ill
quickly with flu-like symptoms, back pain, and a headache. He was
promptly transported to the Emergency Room, where he had a CT scan of
his head and then a lumbar puncture with spinal fluid suggesting a gram-
negative meningitis. He was immediately begun on intravenous
antibiotics targeting that and placed on a ventilator machine because of
his critical condition and coma. Within twenty-four hours the gram-
negative bacteria in the spinal fluid was confirmed as E.coli. An infection
more common in infants, E. coli meningitis is very rare in adults (less
than one in 10 million annual incidence in the United States), especially
in the absence of any head trauma, neurosurgery, or other medical
conditions such as diabetes. Dr. Alexander was very healthy at the time of
his diagnosis and no underlying cause for his meningitis could be
identified.
The mortality rate for gram-negative meningitis in children and adults
ranges from 40 to 80 percent. Dr. Alexander presented to the hospital
with seizures and a markedly altered mental status, both of which are risk
factors for neurological complications or death (mortality over 90
percent). Despite prompt and aggressive antibiotic treatment for his
E.coli meningitis as well as continued care in the medical intensive care
unit, he remained in a coma six days and hope for a quick recovery faded
(mortality over 97 percent). Then, on the seventh day, the miraculous
happened—he opened his eyes, became alert, and was quickly weaned
from the ventilator. The fact that he went on to have a full recovery from
this illness after being in a coma for nearly a week is truly remarkable.
—Scott Wade, M.D.