105: Novel, Unidentified Interfibrillar Syncytial Virus — a Case Report

New England Journal of Medicine Case Study

CASE:

Chief Complaint: Syncytially adhering corpse to male patient.

Present Illness: A 54-year-old mortuary assistant, grave-digger by trade, was brought to the Emergency Department by EMS. In otherwise apparent good health, he presented as an agitated man distraught over a corpse tightly adhering to his entire ventral surface--contiguous with his ventral pelvis, abdomen, and chest.

Clinical Course: Over several hours, as the patient grew weaker, serial serum levels of glucose, potassium, and sodium began to fall far below the lower limits of normal. His hemoglobin fell as well, and his pulsOx went from 98% to 89% in just an hour. Fluid support was aggressively administered.

The dormant, adhered corpse, alternately, was observed undergoing revitalization, in an apparent retrograde metabolic exchange between their two bodies.

The brisk intravenous fluid and electrolyte replacement into the patient was negated by a consumptive active transport, apparently, through the microfibrillar network between them.

Laboratory: A needle biopsy from between where their abdominal walls interfaced contiguously was read out by Pathology as an adherence between them that was, microscopically, a

"...non-stratified, non-laminar interfibrillar fusion"

...extending from both the patient's and the corpse's epidermis, through to the dermis of each, and then subsequently into each respective subcutaneous tissue, fascia, and finally ending in confluent vascular anastomosis. An aggregate of foreign bodies were cited, identified as a...

"...novel viral microbiome."

Therapeutic Course: Attempts as mechanical separation resulted in exsanguination voluminous transfusions were unable to counter. The patient became combative from the pain until he collapsed into catatonia; whereupon, the corpse became combative.

General anesthesia was administered to both the patient and the corpse and the conjoined bodies (the "conjoints") were transported to the surgery suite for surgical separation.

In the OR, they were prepped and draped in left lateral decubitus position, and surgical separation begun with scalpel and electrocautery; hemostasis was achieved with tamponade and 10 units of fresh frozen plasma.

The patient/corpse amalgam was then turned to right lateral decubitus position and the same methodology for separation implemented. The PACU was readied to receive two post-anesthesia care admissions.

Clinical Outcome: Surgical separation under general anesthesia was successful. Of the two conjoints, the patient did not survive.