A 24-year-old woman arrived at the hospital unable to walk. Pain burned from her thighs to her feet, and her legs had changed color, as if something inside were slowly shutting them down.
Doctors at the Government Medical College in Thiruvananthapuram, India, found something they did not expect to see in the 21st century: ergotism, the same disease that in the Middle Ages was called “hellfire” and attributed to curses or witchcraft. The real cause was far more mundane. The patient was taking ergotamine for her migraines, and that substance, combined with her HIV antiviral medications, caused the arteries in both legs to narrow severely.
The case, published in The New England Journal of Medicine, ended with treatment arriving in time to save her legs, but not a toe on her left foot, which gangrene had already claimed. A reminder that even the most common medications can conceal dangerous combinations.
