5 Common Conditions That Could Get Serious

Why Seeing Your Physician Is Never a Bad Idea

Every day many of us are aggravated by some common health issue that’s limited in how much damage it can do. Sometimes, however, seemingly minor health issues or more common conditions can become more serious and require medical attention. However uncommon, here is a look at a few serious things that might result from five common ailments and conditions.

1
Necrotizing Fasciitis

Eschar
Heel Eschar (Dead Skin and Tissue) in Person With Diabetes. Photographer/Getty Images

Most people who practice good hygiene and are healthy with a strong immune system never develop necrotizing fasciitis (in other words, “flesh-eating” bacteria). However in some, a simple skin infection can spread throughout the body leading to blood infection, limb amputation, and so forth.

With necrotizing fasciitis, bacteria spread from the soft tissue to the fascia, or flat layers of connective tissue that surround blood vessels, nerves, fat, and muscles. The toxins produced by these bacteria also destroy surrounding tissue.

There are two common types of necrotizing fasciitis.

Type 1 necrotizing fasciitis is a polymicrobial infection, which is caused by different types of bacteria, both aerobic and anaerobic. Of note, aerobic bacteria grow in oxygenated environments; whereas, anaerobic bacteria don’t require oxygen to grow. Traumatic wounds, such as those caused by animal and human bites, typically contain a mix of aerobic and anaerobic bacteria.

Type 2 necrotizing fasciitis results from infection with skin bacteria, including Staphylococcus aureus, methicillin-resistant Staphylococcus aureus (MRSA), and Streptococcus pyogenes.

With necrotizing fasciitis, a skin infection can become very red (erythematous) with the formation of bullous (bubble-like) lesions and bruising (ecchymosis). Furthermore, drainage of serosanguinous fluid or pus also occurs. Finally, the skin eventually dies (becomes necrotic) and can become gangrenous.

Necrotizing fasciitis can affect any part of the body—including the upper extremity and abdomen—however this disease mostly affects the lower extremities. In addition to skin changes, here are some other signs and symptoms of necrotizing fasciitis:

  • Pain out of proportion to the appearance of the infection
  • Swelling and numbness of surrounding area
  • High fever
  • Crepitus, or gas in tissues

Treatment of necrotizing fasciitis occurs in a hospital setting and involves the following:

  • Antibiotics that cover MRSA and other drug-resistant strains of bacteria
  • Surgical debridement or removal of dead tissue, which can mean amputation
  • Fluid resuscitation (think intravenous fluids)
  • Wound management (think negative-pressure wound therapy)

Here are some risk factors that predispose a person to the development of necrotizing fasciitis:

  • Diabetes mellitus
  • Poor nutrition
  • Recent operation
  • Decubitus ulcer, or pressure ulcer, which commonly results from a person lying immobile for long periods of time
  • Intravenous drug use
  • Alcoholism

The best way to deal with necrotizing fasciitis is to avoid it in the first place, especially if you are susceptible to this type of infection. For instance, if you do develop a skin infection or wound, keep it covered with clean and dry bandages. You should also wash your hands often and avoid submerging the lesion in pools, whirlpools and other bodies of water.

On a final note, necrotizing fasciitis that affects the (mostly male) genital region is called Fournier gangrene.

2
Upper Respiratory Infections

Upper Respiratory Tract
Diagram of the Upper Respiratory Tract. Photographer/Getty Images

Upper respiratory infections (URIs) are exceedingly common and a common reason why many people seek care from a physician. We all get URIs from time to time.

Most URIs are caused by viruses and are self-limited, which means that they will go away on their own without treatment. Rarely, however, a URI can become severe and may be a manifestation of a superinfection, or an infection with additional infectious agents. Of note, bacterial URIs are treated with antibiotics, such as amoxicillin, penicillin, ceftriaxone and so forth.

Here are some typical URIs:

For the most part, URIs can be treated in an outpatient or ambulatory setting. Occasionally, URIs are pretty serious and require treatment in the hospital—especially in children.

One type of URI that requires prompt medical attention is epiglottitis. The epiglottis is a flap of cartilage that covers the trachea, or windpipe, when you swallow (so as not to aspirate or get food in the trachea). Epiglottitis refers to swelling of this tissue secondary to infection with a bacteria or virus.

Epiglottitis can cause spasms of the epiglottis or otherwise obstruct the trachea and cut off the air supply to the lungs, resulting in cardiac arrest and even death. Treatments for epiglottitis include intubation, wherein a tube is placed into the trachea, intravenous fluids and antibiotics, and corticosteroids to help with inflammation.

Fortunately, epiglottitis is pretty rare because we now have a vaccine for H. influenzae type B (Hib), which is the most common cause of this condition.

3
Headache

Headache
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Headaches are the most common neurological disorder, with 50 percent of all people experiencing​ a headache at some point during a year, and 90 percent of people experiencing a headache at some point in their life.

Most of the time, headaches are benign and either go away on their own or after taking Tylenol (acetaminophen) or some other over-the-counter pain reliever. Sometimes, however, headaches can be indicative of something much more concerning like stroke. About 25 percent of people who experience acute stroke also have associated headache.

Stroke is the fifth leading cause of death in the United States. According to the CDC, 795,000 people each year have a stroke and 130,000 people die of stroke.

Here are some common signs and symptoms of stroke, which occur abruptly:

  • Numbness or weakness of an arm, leg or entire side of the body, which depends on the location of the stroke
  • Trouble seeing
  • Trouble walking due to dizziness or loss of balance
  • Confusion
  • Trouble talking
  • Headache

Of all these signs and symptoms, headache secondary to stroke is probably most overlooked by clinicians when diagnosing stroke. Typically, clinicians concentrate on other (objective) signs like numbness or weakness and are worried about quick management of stroke. Please remember that with stroke, time is of the essence and swift treatment can prevent future disability.

Headache can be associated with several types of stroke including the following:

  • Intracranial hemorrhage
  • Subarachnoid hemorrhage
  • Giant cell arteritis
  • Carotid or vertebral arterial dissection
  • Intracranial venous sinus thrombosis.

In people who experience stroke, headache severity has nothing to do with the size of the infarcted area. Furthermore, unilateral headache, or headache that occurs on one side of the head, is usually caused by stroke on the same side of the head. Of note, further research needs to be done examining the clinical significance of stroke-related headache.

4
Depression

Depression
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Before we look at depression as a risk factor for suicide, please understand that the vast majority of people who experience depression never commit suicide.

Specifically, according to the National Institute of Mental Health (NIMH) in 2014, 15.7 million Americans experienced one major depressive episode; whereas, in 2011 according to the Centers for Disease Control, there were 41,149 deaths attributable to suicide.

Furthermore in an informative booklet titled “Depression: What You Need to Know,” the NIMH stresses the following:

  • Depression is a real illness
  • Depression affects people in different ways
  • Depression is treatable
  • If you have depression, you are not alone

Nevertheless, risk of suicide should be assessed in all people with symptoms of depression.  Suicide is a substantial problem and is a top 10 cause of death in all age groups.

Here are some risk factors for suicide:

  • gender (older white men are at greatest risk)
  • alcoholism
  • physical illness
  • lack of social support
  • psychosis
  • recent humiliation

Additionally, adolescents with depression as well as LGBT youth with depression are at particular risk.

Worrisome signs of suicide risk include explicit expression of suicidal intent, hopelessness (depression) and a well-formed plan.

If you or someone you know feels suicidal, you must tell your physician, friend, family member or call the National Suicide Prevention Hotline at 1-800-273-TALK or 1-800-273-8255.

One final note about depression: Although depression is included in this list along with other items that could often be considered minor annoyances—like a skin infection or a headache—for many people who experience depression, there's nothing minor about this condition.

Depression is included on this list because depression is more common than many people realize. Furthermore, we should always strive to attain insight into either depressive symptoms that we experience or depressive symptoms that are experienced by loved ones. 

If depression and hopelessness accompany other indicators of suicide risk, please seek help immediately. Depression is treatable, and in many instances, suicide can be avoided with proper treatment and care.

5
Chest Pain

Chest Pain
Photographer/Getty Images

When many people think of “chest pain,” heart attack, or myocardial infarction, comes to mind. However, there are many more benign causes of chest pain; thus, no one should automatically assume that all chest pain means heart attack.

Heart pain indicative of a heart attack tends to be unrelenting, diffuse and radiating when it first presents. In other words, this pain isn’t typically fleeting. Additionally, symptoms of heart attack can be “atypical” and include more than just chest pain or discomfort per se. They may present as pain, discomfort or pressure in the stomach, arms, back and so forth. Finally, such symptoms are typically associated with other signs symptoms, including sweating, nausea, fatigue and syncope (fainting).

Chest pain that is transient, pinpoint, reproducible or improves may indicate a more benign cause such as

  • a cracked rib
  • a pulled muscle in the chest wall
  • herpes zoster (shingles)
  • asthma
  • pneumonia
  • gastroesophageal reflux disease (GERD) (“heartburn”)

6
It's Never a Bad Idea to See Your Physician

Physician
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Yes, it’s true that even some of the more mundane health issues that we all experience at one time or another, including a headache or an abscess, could conceivably become quite severe. Fortunately, however, many health grievances that we battle through on a daily pain resolve on their own.

Nevertheless, if you ever feel the need to seek help or treatment for even the most seemingly minor issue, it’s always a good idea to make an appointment with your primary care physician.

Please remember that there’s never such a thing as a “wasted” physician appointment. Even if your provider ends up simply reassuring you, she will have made you feel better and generally assessed your health and well-being. Finally, such a visit can serve as a prelude to your yearly physical or check-up.

Sources

Chin-Hong P. Upper Respiratory Tract Infections. In: Levinson W. eds. Review of Medical Microbiology and Immunology, 13e. New York, NY: McGraw-Hill; 2014. 

Eisendrath SJ, Cole SA, Christensen JF, Gutnick D, Cole M, Feldman MD. Depression. In: Feldman MD, Christensen JF, Satterfield JM. eds. Behavioral Medicine: A Guide for Clinical Practice, 4e. New York, NY: McGraw-Hill; 2014. 

Raghunathan S, Richard, B, Khanna B. Causes and clinical characteristics of headache in ischaemic stroke. Progress in Neurology and Psychiatry 2008.

Usatine RP, Smith MA, Chumley HS, Mayeaux EJ, Jr.. Chapter 122. Necrotizing Fasciitis. In: Usatine RP, Smith MA, Chumley HS, Mayeaux EJ, Jr.. eds. The Color Atlas of Family Medicine, 2e. New York, NY: McGraw-Hill; 2013. 

Vestergaard K, Andersen G, Nielsen MI, Jensen TS. Headache in stroke. Stroke 1993.

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