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.
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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 increase 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.
Kevin Pho, MD, is a practicing, board-certified internal medicine physician and the founder and editor of KevinMD, which he built from scratch in 2004 to give clinicians and patients a place to be heard. Over two decades, it has become one of the most recognizable physician-led publications in health care, drawing more than 7 million annual page views and over 500,000 followers across social media. He still sees patients in primary care in Nashua, New Hampshire, the practice he says keeps the platform honest.
He is the host of The Podcast by KevinMD, a daily, 15-minute show that has surpassed 2,000 episodes and 2.6 million IAB-certified downloads, featuring physicians, patients, caregivers, founders, and health care leaders in conversation about what they actually see and do. He is also a national media commentator and the coauthor of Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices.
An acclaimed keynote speaker, Kevin speaks nationwide to clinicians and non-clinicians on health care, digital media, physician leadership, and burnout. His signature keynote, “Connect and be heard: Make a difference in health care with social media,” traces his social media journey since 2004 and inspires audiences to strengthen the doctor-patient relationship, make their voices heard in health reform, and turn the tide against clinician burnout. He is the founder of Physician Speaking by KevinMD, a physician-run speakers bureau, and is available for speaking opportunities.
Kevin earned his medical degree from Boston University School of Medicine and completed his internal medicine residency at Boston University Medical Center. The New York Times called KevinMD “a highly-coveted publishing place for doctors and patients,” and Forbes called it a “must-read health blog.” He is an inductee of the Healthcare Internet Hall of Fame, a recipient of the American Medical Writers Association McGovern Award, and a New Hampshire Magazine Top Doctor.
