Madonna Reportedly Discharged From Hospital After Serious Bacterial Infection, Here Are Possible Causes

Three words that you don’t want to hear together are “serious”, “bacterial” and “infection.” Those are the words that Guy Oseary, the manager for Madonna, used in an Instagram update on the 64-year-old pop singing star this past Wednesday. He had posted that Madonna had “developed a serious bacterial infection which led to a several day stay in the ICU.” In this case, ICU presumably stood for intensive care unit and not Irish Chess Union. So things must have been harrowing for the star born as Madonna Louise Veronica Ciccone. But now Madonna is reportedly now “feeling better” and “resting” at home, according to what Melody Chiu wrote on June 29 for PEOPLE.

Besides what Oseary posted on Instagram, there isn’t much official material from the Material Girl or her camp about what actually happened to her. It seems like Francesca Bacardi was the first to report for Page Six that Madonna had been found unresponsive, was taken to a New York City hospital, and subsequently got intubated with a breathing tube that was removed on Wednesday. At the time, Bacardi didn’t cover how long the bacterial infection had been going on before Madonna had been hospitalized. On Thursday, though, TMZ indicated that Madonna had suffered from a low-grade fever for about a month but ignored her symptoms and didn’t get evaluated by a doctor because she was focusing on preparing for her Celebration tour. She was supposed to begin this 84-date North American and European tour on July 15 in Vancouver, Canada.

The phrase “serious bacterial infection” is very non-specific and does not say specifically what type of bacteria had infected Madonna and where. Using this phrase is a bit like saying, “Someone did something really bad to me.” There are many, many different types of bacteria out there. In fact, you are typically covered with bacteria, no matter how times you take a shower and slap yourself. Fortunately, less than one percent of all bacteria out there can cause illness in you. In fact, many bacteria are your friends and help your body perform a lot of your daily bodily functions. So remember, no matter how lonely you may feel, you are never really alone.

But troublemaking bacteria are a different story. They can enter your body in many different ways. Think about how many different openings your body has. Plus, breaks in you skin—even breaks that are too small to see—can allow bacteria to go where they are not supposed to go. That being said. Many bacterial infections don’t progress to serious stages. Some resolve without treatment—such as when you get a bout of gastroenteritis after eating a piece of pizza that you found wedged in between your sofa cushions. Others can be readily treated with antibiotics—such as many bactrial infections of your skin.

Madonna’s bacterial infection presumably went well past this try-some-antibiotics stage, though. Getting intubated is not something that happens every day and is done just for the fun of it. You don’t typically say, “This weekend, I’m going to watch Netflix, eat some cake, and get intubated, not necessarily in that order.” Intubation is when someone inserts a breathing tube—called an endotracheal tube (ETT)—through your mouth or nose down into your trachea so that oxygen can be delivered either from a bag that’s pumped manually or from a machine down to your lungs.

There are really only two reasons why you should get intubated. One is if your major airways are somehow blocked or damaged to the point where air can’t get through them. This can happen if you suffer some type of injury or trauma to your chest or the surrounding area. The other reason to get intubated is if you can’t breathe normally on your own.

On the list of things that you have to do each day, breathing ranks pretty darn high. So your body has a complex system of mechanisms to ensure that you don’t forget to breathe, even when looking at some avocado toast. You may lose your ability to breathe if you suffer a cardiac arrest, your respiratory muscles become exhausted, or you lose your respiratory drive in some way. Your respiratory drive results from the complex system of chemical, mechanical, behavioral, and emotional factors that keep you breathing throughout the night and day. This drive can go away if your are under anesthesia or the influence of other types of medications. You can also lose this drive when key parts of your respiratory drive system are damaged or you get very sick with something like sepsis. But more on this sepsis thing later in, oh, less than “4 Minutes.”

There is certainly a range of possibilities of why Madonna may have required intubation after a serious bacteria infection had left her unresponsive. In the absence of further information, two of these possibilities seem most likely. One is that the serious bacterial infection was in her lungs—such as what happens when you have a bad pneumonia—leaving her eventually unable to effectively exchange enough oxygen and carbon dioxide in her lungs. When you can’t get enough oxygen, you can end up passing out, because your body essentially says, “WTF is happening. Where the f— is the oxygen?” So, when you try to hold your breath, passing out can be a protective mechanism to force you to start breathing again.

The other leading possibility is that Madonna developed sepsis. Sepsis is when you have an infection and your immune system kind of overreacts. Although a wide range of bacterial infections can lead to sepsis, the most frequent culprits are Staphylococcus aureus, Streptococcus pyogenes, Klebsiella spp., Escherichia coli (otherwise known as E. coli or maybe Eeeee coli), and Pseudomonas aeruginosa. Usually, your immune system is your friend, helping you fight a bacterial infection. But sometimes your immune system flips out and goes all Loki on your body’s tissues and organs. This can lead to widespread inflammation all over the place and trigger all sorts of chain reactions throughout your body that can cause blood clots to form all over your body, your blood vessels to relax abnormally, and, in turn, reduced blood flow to your different organs. And your organs need blood to survive.

Typical symptoms of sepsis include changes in breathing patterns, mental status, and sweating. Now, this is when there’s no obvious reason for such changes. If you are looking at a piece of cake and experiencing rapid, shallow breathing, sweating, shivering, and feeling lightheaded, then maybe it’s not sepsis. On the other hand, if you are experiencing such unexplained symptoms and have been having symptoms of a urinary tract infection, pneumonia, or other infection for a while, then keep sepsis in mind and contact a medical doctor as soon as possible. This should be a real medical doctor and not someone who thinks cracking your spine is the cure to everything.

Sepsis can very quickly worsen to septic shock, which is when your blood pressure may drop precipitously. This is when you may not even be able stand up or stay awake and conscious. You may get really confused. About 30% to 40% with septic shock end up dying, according to the Mayo Clinic. The bottom line is that if someone asks you if you would like some sepsis, just say, “No” and slowly back away from the person.

Again, besides Oseary’s post, there has been little official word on what’s happened to Madonna. Typically, doctors don’t go blabbing about what happens to their patients. So, take everything you hear with a grain of salt—but not too much salt, because too much salt can be bad for you.

One thing’s clear, though. If you do have any signs of a persistent infection, such as a fever, don’t ignore those signs. And don’t try to treat such symptoms yourself with something like more cowbell. Instead, see a doctor. A real medical doctor.