Bernie Mac, pneumonia, and sarcoidosis

Bernie Mac, pneumonia, and sarcoidosis

Comedian Bernie Mac dies at age 50 from pneumonia. Sad news.

He had been recently hospitalized, and as recently as two days ago, it was reported he was stable and responding well to treatment. What happened?

There is very little medical information to go on. It was known that he had sarcoidosis, a multi-system immune disorder that primarily affects the lungs. The overall death rate from this disease is less than 5 percent, and generally caused by the consequences of progressive disease, rather than an acute event.

This leads me to believe that his death was less likely to be related to the sarcoidosis, but rather due to the pneumonia itself. This shows the seriousness of the oft-overlooked, yet common, community-acquired pneumonia.

Most cases of pneumonia that require hospitalization respond to antibiotic therapy within 72 hours. About 10 to 15 percent do not, and if Bernie Mac was admitted to the ICU, the initial failure rate reaches as high as 40 percent. These “non-responders” have a significantly higher mortality rate.

Possible causes for a non-response include an atypical or drug-resistant bug, or unusual pathogens (like fungi). Concurrent diseases in the patient, like cancer, heart, lung or neurological disease, also increases the non-response rate.

The overall mortality rate for hospitalized pneumonia is 8 percent. In those who do not respond within 72 hours, this jumps up to 25 percent. Bernie Mac had a prolonged hospital stay, suggesting that he did not initially respond well to antibiotic therapy. This fact alone gave him a much cloudier prognosis.

What could help? Vaccines for one. Studies have shown that people who obtain their pneumococcal and influenza vaccine have better outcomes in cases like these.

Although pneumonia is common, it can be serious. Unfortunately, sometimes it takes the death of a relatively young celebrity for the media to remind us of this.

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  • Anonymous

    Valid points, Kevin. But do not dismiss the role sarcoidosis may have played in exacerbating his pneumonia.
    While everything here is speculation, his history of pulmonary sarcoidosis could have certainly left residual scarring that would make it harder to clear his pneumonia. If his disease was recently active again, he may have also been on a course of immunosuppressive therapy (his PR note about the disease in 2005 indicated “the actor receives multiple treatments for the condition”; prednisone would be most typical.
    It is also worth noting that at the time of his disclosure about the disease four years ago he was admitted for double pneumonia.

  • Anonymous

    I wonder if Bernie Mac used the same family doctor that he was comfortable and always used for years or did he have the best medical care money could buy? His generation was the “I’m a man I dont need no damn doctor” generation.
    Being drug resistant with a really informed staff of doctors- he could of used fauges(a really gross antibiotic made from feeces that is grown by nuns)that costs $1000.00 a treatment but is the end of the line for many people. This rare type of antibiotic has been proven and cured many people that have antibiotic resistance and are on the verge of death.
    I think Bernie Mac would of thrived off a combination of regular world medicine mixed with natural homopathic care to help raise his blood cell count. The western meds suppressed his immunity so well that it left the rest of his body open for attack.
    Bernie Mac is gone,and the world lost a personality that is so rare

    so unique and so damn good.

  • Anonymous

    It sounds to me very much like Bernie Mac may have actually died from SEPSIS being caused by the pneumonia. My mother just recently died suddenly from sepsis, after contracting a staph infection on her heart valve — one day she was in perfect health, then after a few days of thinking she had a simple flu (fever, aching back, exhaustion – much the same as Bernie’s symptoms), she was rushed to the hospital where she presented as septic. 17 days later, after a valiant fight, the sepsis was too far out of control, and she went into multiple organ failure and was gone. Since then, I’ve learned a lot more about sepsis — one, that it is one of the largest killers behind cancer and heart disease, yet it’s rarely discussed or understood, largely because sepsis-related deaths always seem to be reported as something else (i.e. “they died from ‘complications of pneumonia,’”) — such as in the cases of both Jim Henson and Christopher Reeve. I suspect there is an extremely good chance this happened in Bernie Mac’s case, since sepsis, after all, is an immune system response, and Mac’s immune system was already extremely weakened and compromised due to his sarcoidosis. Recently it was reported that Cameron Diaz’s father ALSO suddenly succumbed to “complications from pneumonia,” before which he was the “picture of health”…just like my Mom. In trying to explain to people what happened to my mother, I have found that nearly NOBODY has even HEARD of sepsis…and since there is no big national effort right now to promote awareness and research funding for this rapid-moving killer, I wish that at the very LEAST the press (and the doctors that PROVIDE this information to the public!) would start reporting this condition ACCURATELY — for WHAT IT IS. When someone dies from SEPSIS, just SAY SO…”complications from pneumonia” is much too vague and sepsis is a medical condition SO serious that it deserves to be better understood. Because the sooner it is detected and a patient is treated, the better. If you could possibly post some thoughts or explanation about sepsis to your readers, it would be much appreciated…thanks. My heart goes out to Bernie Mac’s family…I understand the shocking loss they must be feeling. The scariest thing about sepsis is that the slightest infection could bring it on, in even those who seem to be in nearly perfect health. It can take any of us — at any age, at any time. I would like to see a bigger effort on the part of the medical community to bring some knowledge of this EXTREMELY dangerous condition to the mainstream public.

  • Anonymous

    I have been trying to learn more about these “complications of pneumonia,” too, since I am a survivor of streptococcal toxic shock syndrome. That is what sepsis from strep causes. Sepsis just means the bacteria has gotten into your bloodstream, where it is not supposed to be. A lot of sepsis is caused by staph, but other bacteria can cause it, too. I also was perfectly healthy, but came down with what I thought was the flu. Within 3 days, I was on death’s doorstep in the ICU with multiple organ failure. Fortunately, I survived after 3 weeks in the hospital and 3 liters of fluid removed from my left lung. I had no idea a person could get so sick so fast. Anyway, it was a huge shock to all of my family, and I surely do understand the rapidity with which it can strike. So many people have never heard of this stuff.

    My prayers go out to the Bernie Mac Family.

  • Anonymous

    I am in full belief that Mr. Mac passed away from sepsis. As a few posters below had mentioned, this is a huge killer that the general public knows anything about. My 28 year old very healthy 28 year old wife went into septic shock 8 months ago from pneumonia and Benie’s situation (or nightmare) sounds very similar to that. In ICU for 3 weeks and at one time was 40 lbs over her weight due to all the fludids pumped into her…a true nightmare Bernie Mac reminded me of. My wife against all odds and doctors odds pulled through….a true miricle. RIP Mr. Mac.

  • Glycoside

    Perhaps an autopsy should be carried.

  • Anonymous

    so sad… Rock and Ice-Cube pay tribute to him, found this in an article on KIIS FM's web site: http://www.kiisfm.com/cc-common/news/sections/newsarticle.html?feed=&article=4078227

  • Anonymous

    I just read in an article that Northwestern is a highly reputable hospital but it is also a “learning hospital” with new interns beginning in July. Someone had question his medical team in this article.
    But I believe Mr. Mac died from nothing more than a Staph infection and his medical team is not even allowing his wife and family to know this because of lawsuits. The doctors have said the Pneumonia was NOT related to his Sarcoidosis, and “the Infection” was caused by the meds he had been on (for how Long we dont know) that suppressed his Immune System (for how long had it been suppressed?).
    So put it all together with the ventilator tubes and IVs and being in there for 3 weeks I think even the lay person will realize what happened to Bernie Mac. May your Soul be at Peace with the only True God and may that same God be with your family.

  • Anonymous

    I agree with the other posters on “sepsis” as being the true culprit. The article on his death also says he developed a second strain of the pneumonia. If, as the doctor mentioned, he came in with community-acquired pneumonia, he most surely developed a more virulent strain (thus leading to the sepsis) of the hospital or infamous nosocomial pneumonia – which is MRSA. But the complications were, I am convinced, from the bacterial or sepsis response. My sister died in 2007 after being almost 24 days in the hospital for MRSA pneumonia that she acquired in her prior stay in the hospital (a few days before). However, her death was “iatrogenic” in nature (death by doctor) because the thoracic surgeon punctured her lung during a botched decortication. However, the sepsis caused extreme fluid build up in her left lung and she began to go into kidney failure. That’s what sepsis does for the body; it creates an immune response that, in what sounds like the case in Bernie Mac’s death, causes the organ system to shut down. My heart goes out to the family….

  • Anonymous

    i believe for sure that he died from septic shock. I myself went into septic shock from what i thought was just a cough. I layed around all day feeling so sick but not able to describe my pain because of the lack of oxygen to my brain. when people are going into shock nothing makes sense you feel so confused and out of it. I remember that all i wanted to do was go to sleep and if i just went to sleep i would have died. It is all about the timing with septic shock. If you go to the hospital to early they can just say that you have a cough and give you some antibiotics and you end up going home and falling asleep and never waking up. In my case I got to the hospital just in time because the shock hit and my blood pressure dropped to 50 and they knew right away what to do. I was in the icu for 2 weeks. septic shock is a very scary killer and people healthy or sick need to be aware of this. This is what he died from I knew it the very morning that I saw the horrible news.

  • tahila

    First of all I was and am greatly saddend by the death of Bernie Mac. He was one of my favorite comedians also one of my favorite actors. I also have sarcoidosis, have had it for about twenty years. For the first ten or so years I could deal with it ok, now and especially within the last eight years I am having a very hard time breathing and the symptoms have greatly increased. So I can sympathise with what Bernie Mac and his family and those who were close to him went through. My heart goes out to all who has to deal with this nasty illness and may God bless you all.