Medical and scientific journals withdraw or retract articles on a regular basis, usually because of errors discovered or questions raised about the research described. A few days ago, however, a highly unusual “correction” appeared in the prestigious British Medical Journal announcing the withdrawal of a case study titled “Cutaneous larva migrans with pulmonary involvement.”
The article, which was not retracted, contained no errors. The BMJ simply said in the undated note that “with no admission of liability, BMJ has removed this article voluntarily at the request of the patient concerned.”
Here’s what happened.
While sunbathing on a beach in Martinique, a British woman suddenly felt a burning sensation on her backside. The next day, she woke up to find a nasty rash of “red pinprick marks” on her bottom.
Soon her husband broke out with the same rash in the same unfortunate place.
While they received treatment in Martinique in the form of steroid cream, antibiotics and antifungal medication, the irritation did not subside. The voyage home, 10 days on a cruise ship, must have been uncomfortable.
Nor was the rash gone when they got home.
So they went for treatment at Addenbrooke’s Hospital in Cambridge, England. Doctors there found their backsides “infested by worms,” as the Cambridge News reported. The couple found relief from a combination of medications.
The doctors thought their case so interesting they wrote it up for the British Medical Journal. The journal did not use the name of the patients. But as journals often do in case studies, it accompanied the text with photos — in this case, of their backsides, from different angles, in full color.
The couple gave their permission and were warned that journal articles were often read by journalists as well as medical professionals, the BMJ said in an email to The Washington Post. But the couple apparently had not anticipated the potential for tabloid interest.
By mid-January, their buttocks were spread across Britain and, indeed the world, with headlines such as “Til Rash Do Us Part” in The Sun and “Caribbean getaway leaves a nasty souvenir” in the Daily Mail.
These were not your typical titillating tabloid photos. They were shots from various distances of behinds bearing inflamed red blotches.
Many tabloid readers found them gross.
“A description would have done,” commented one reader of Britain’s Daily Mail, adding that “we didnt need to see the evidence.”
“Does the DM pixelator have a day off today?!?,” wrote another.
“Thanks — that’s put me right off my cheese & ham toastie,” wrote a third.
Like the journal article, the stories did not include the names of the patients or say where they lived or when they visited Martinique.
But there was enough information — the age of the woman, the island, the cruise, the hospital — that the couple apparently felt that acquaintances conceivably could have made the connection.
One of the patients — the journal didn’t say which one — got in touch with BMJ and “explained that they were concerned about being identified by close friends and/or colleagues, as a result of the subsequent media coverage,” the publication said in a statement emailed to The Post.
“Prior to publication of the article, written consent from the patient was obtained,” said the statement. “By signing the consent form, the patient indicated their understanding that complete anonymity could not be guaranteed and it was also made clear in the consent form that BMJ publications are viewed by many non-doctors, including journalists.”
“The patient’s concerns did not amount to a legal threat,” it added. “… Nevertheless, the journal took the editorial decision to remove the article, because of the distress the patient had suffered.
” … To be clear, the removal of the article does not amount to a retraction and the journal stands by its factual content.”
A spokesman for the hospital, part of Cambridge University Hospitals, also issued a statement: “The case study was shared with the BMJ with the aim of medical advancement, to aid other clinicians, and potentially help the treatment of future patients with similar conditions. Because the article was being picked up in nonmedical publications, a request was made for it to be removed.”
In fairness to the tabloids, there was some news and public service value to the stories useful to people planning on visits to tropical or subtropical beaches.
The diagnosis, as described by Livescience, quoting the no-longer-accessible case study, was “cutaneous larva migrans,” otherwise known as a hookworm infection.
According to the Centers for Disease Control and Prevention, people pick up this nasty parasite from the feces of dogs and cats. If those dogs and cats leave their waste on a beach, sunbathers can contract the infection.
In the case of the British couple, the infection found its way into their lungs, causing coughing, and in the woman, shortness of breath and pain.
The advice from the CDC for those visiting such beaches: “wear shoes and use protecting mats or other coverings to prevent direct skin contact with sand or soil.”
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