How did leftover noodles lead to teen having their fingers and legs amputated?

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A popular YouTube page has prompted interest in the story of a 19-year-old student who lost both of his legs and all 10 of his fingers after developing a rare condition from eating leftover noodles.

Last week, Dr. Bernard Hsu, an American YouTuber and toxicologist, uploaded a video to his YouTube channel "Chubbyemu" detailing the bizarre case of the student referred to as "JC." The video garnered more than 1.3 million views in less than a week, with many viewers wondering how something so seemingly innocuous as eating leftover noodles could turn into a life-threatening illness.

According to the case, first published in the New England Journal of Medicine in 2021, JC was admitted to the paediatric intensive care unit (PICU) 20 hours after eating “rice, chicken and lo mein leftovers from a restaurant.”

The teen presented with multiple organ failure, rash, shock, high blood pressure, fever, pale skin and was vomiting a "green-ish yellow" bile that did not resemble food.

“Doctors started to notice a rash containing small spots emerging all over his body,” Hsu explained. “At first, this mottled appearance looked like bruises, but then they became a deep reddish brown, red defined at the edges.”

Blood and urine tests diagnosed JC with Neisseria meningitidis, also known as meningococcal disease, a life-threatening disease caused by bacteria.

JC's rashes were purpura fulminans, which according to the University of Utah, a bacterial disorder that causes by rapid skin necrosis caused by blood clots in the dermal layer of the skin. These clots occur when when blood vessels in the skin collapse, prompting the protein that cause blood to clot becomes overactive and create "too many clots."

The clotting prevents blood vessels from delivering oxygen to your tissue and organs, which can cause them to shut down. For JC, the infection on his legs and fingers were so severe that they required amputation to save his life.

Although Hsu says doctors were unsure why the Neisseria meningitidis was present in his food, it was definitely the leftovers that caused his illness. JC's roommate also vomited after eating the food, but didn't have the same reaction as JC.

Several incidents of leftovers causing severe illness and death

Although rare, there have been several headline-making incidents where bacteria from leftovers have been life-threatening, if not fatal.

In most cases, the patients involved died or became ill after eating pasta that had been left at room temperature for too long (it's unclear how JC's food was stored).

According to Lynn K. Richards, a former health inspector and trainer with TrainCan, which offers food-safety training and certification, foods left at room temperature for two hours or more should be thrown out.

In some cases, the bacteria that forms is heat-resistant, meaning reheating your food won't make it any safer to eat.

"The toxin cannot be killed by heat,” Richards said in a 2019 interview with Yahoo Canada. “Bacteria that produce toxins can’t be controlled; you can’t just cook it all out. A toxin is not a microbe; it’s a chemical. It’s a poisonous substance.”

“Toxins do not smell,” she added. “You can’t see them, taste them, or smell them. That’s why they’re so dangerous.”

Microorganisms grow quickly when the temperature is between 4 degrees Celsius (40 F) and 60 degrees Celsius (140 F), according to TrainCan. This range is called the temperature danger zone. The longer that food is in the danger zone, the more bacterial will grow.

Hot food needs to stay hot and cold food needs to stay cold.

According to Richards, young people should be educated on proper food handling to help prevent food poisoning.

“With students, they’ve had food cooked for them quite often,” Richards explained. “If they learn how to cook, that’s great, but often they don’t have food safety information that would help them.

“Reheating or cooking does nothing for a toxin,”she continued. “As a health inspector, I think about how the food could have been prepared and who do I trust preparing my food? It’s about risk reduction.”

With files from Gail Johnson.

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