Wedding Preparations Turn Deadly

Aug. 24, 2006 — -- A 25-year-old newlywed returned to New York City from her honeymoon in the Caribbean, excited to embark on a fresh journey with her husband. But instead, within a few months of her wedding, she was in a hospital, on an operating table.

The newlywed, who has requested that her name not be used, remembers waking up in the middle of the night with a very sharp pain in her chest. "I could only describe it as feeling like what I think a heart attack must feel like. I felt like I'd been stabbed."

She went to her doctor and was reassured that a healthy, young Caucasian woman didn't get heart attacks.

The patient said her doctor told her it could be acid reflux or, possibly, stress related to just coming off the wedding. But he gave her an electrocardiogram and an X-ray just to be sure.

During the X-ray, the technician saw something on the left side of the young woman's lung, so she had her get a CAT scan. The newlywed decided to call her godmother, Maureen Zakowski, a thoracic pathologist specializing in the lung region.

She showed Zakowski her X-ray. Zakowski knew what she saw was not normal. "It was a rounded lesion, and all I could think of was that she had developed a tumor."

Zakowski recommended that her goddaughter's chest images be seen by Dr. Michelle Ginsberg, an expert in interpreting lung and chest images.

"The findings were so evident that you could have seen them from across the room," Ginsberg said.

Since the patient was young and -- up to this point -- healthy, doctors believed she had pneumonia or had caught something while she was on her honeymoon.

Ginsberg revisited the young woman's symptoms. "She had chest pain, and she had a cough but really no fever. She had no night sweats."

Doctors questioned if she'd been exposed to any new pets, any new products that could trigger an allergic reaction, or if she'd been taking any over-the-counter medications or illicit drugs. Finally, doctors had one question lingering in their minds: Could it be cancer?

Although the patient didn't smoke, lung cancer was still a possibility. Doctors were also worried that she might have something like lymphoma or Hodgkin's disease.

Doctors told the young woman that they'd need to do a biopsy to determine what she had. "They scheduled me for a full surgery where they would go in through the ribs and remove a large piece of my right lung," she said.

After the surgery at Memorial Sloan-Kettering Cancer Center in New York City, Zakowski examined the mass that was removed. "It had a characteristic appearance that made me think of lymphoma. But as I sliced that tissue, it became obvious that she did not have a tumor at all."

After doctors took a biopsy, the patient got the news. "My surgeon woke me up from surgery and told me 'It's not cancer. ... But we don't know what it is."

The patient said she was relieved to hear she didin't have cancer but was still worried because she'd received no answers about what did have.

Fairy Godmother's Correct Diagnosis

It was Zakowski who realized that her goddaughter had eosinophilic pneumonia, meaning the tumor was made of white blood cells.

"The characteristic appearance was a large number of cells infiltrating the lung tissue, destroying the lung tissue called eosinophils, and it's a particular kind of cell that's present in infections, usually of a parasitic nature, or a reaction to a drug," Zakowski said.

Zakowski asked her goddaughter if she was on any medications. The newlywed remembered that while she was planning her wedding, she had read in a wedding guide that a bride might want to visit a dermatologist to get on a skin regimen to assure clear skin on the wedding day. So she did.

"The dermatologist wrote me a prescription for a very commonly used antibiotic that's given to brides. And I was told that it's very widely used as a preventive precaution to make sure you don't break out on your big day," she added.

She said she took the antibiotic without really questioning it. "I don't think people often think prescription drugs can be dangerous."

According to Zakowski, any drug can do anything in the right environment. "This fairly innocent drug had caused a horrific lung response that could have eventually killed her."

She credits her godmother for diagnosing her condition. "[She] saved my life. Maureen is absolutely my fairy godmother."