A viral video re-enactment of a year-old medical case featured in the New England Journal of Medicine about a student who had both legs below his knees and parts of his fingers amputated after eating restaurant leftovers has created a combination of curiosity and befuddlement.

How can that happen?

The New England man, identified as JC, suffered an extreme response to an infection, a life-threatening medical emergency known as sepsis. The infection frequently starts in the lungs, urinary tract, skin or gastrointestinal tract, says the Centers for Diseases Control and Prevention. About 20 hours after eating chicken, rice and lo mein leftovers from a local restaurant, the man experienced abdominal pain, nausea and vomiting. His skin, warm and dry, had a “mottled appearance.”  He also had chills, chest pain, shortness of breath and blurred vision. His temperature was over 105 degrees, his heart rate 166 beats per minute.

Once hospitalized in Boston, urine and blood tests revealed Neisseria meningitidis, also known as meningococcus, a fatal form of sepsis. The bacteria, after entering his bloodstream, also caused purpura fulminans, resulting in blood-clotting and liver failure.

“Time matters when diagnosing and treating sepsis,“ says Dr. Avital Porat, Medical Director of Quality & Safety at Hartford Hospital.

Doctors ultimately needed amputation to save his life.

The man, according to last year’s report in the New England Journal of Medicine, also shared leftovers with a friend he had been visiting for several days. The friend vomited once, but did not get sicker and did not require hospitalization.

At least 1.7 million adults in the United States develop sepsis each year, according to the National Institutes of Health, resulting in close to 270,000 deaths.

Storing Leftovers

From the Food and Drug Administration:

  • Bacteria grow rapidly at temperatures between 40 degrees and 140 degrees, doubling in number in as little as 20 minutes.
  • Never leave food unrefrigerated for more than two hours.
  • If the temperature is above 90 degrees, do not leave food out for more than one hour.
  • Keep hot food at or above 140 degrees.
  • Keep cold food at or below 40 degrees.
  • Cover leftovers in storage containers or wrap in airtight packaging.

Sepsis: What To Watch

Someone with one or more of these symptoms could have sepsis, according to the CDC:

  • High heart rate or low blood pressure.
  • Confusion or disorientation.
  • Extreme pain or discomfort.
  • Fever, shivering, or feeling very cold.
  • Shortness of breath.
  • Clammy or sweaty skin.

Severe Sepsis

Severe sepsis occurs when there’s organ failure. You must have one or more of the following signs to be diagnosed with severe sepsis:

  • Patches of discolored skin.
  • Decreased urination.
  • Changes in mental ability.
  • Low platelet (blood clotting cells) count.
  • Problems breathing.
  • Abnormal heart functions.
  • Chills due to fall in body temperature.
  • Unconsciousness.
  • Extreme weakness.
  • Septic shock

Symptoms of septic shock include the symptoms of severe sepsis, with extremely low blood pressure.

Who Is at Risk of Sepsis?

  • Adults 65 or older.
  • People with weakened immune systems.
  • People with chronic medical conditions, such as diabetes, lung disease, cancer, and kidney disease.
  • People with recent severe illness or hospitalization.
  • Sepsis survivors.
  • Children younger than 1 year old.

How to Reduce the Risk of Sepsis

Here four ways to reduce the risk of sepsis:

  • Hand Hygiene: Frequent and thorough hand-washing decreases the spread of germs.
  • Vaccinations: Staying up to date with your vaccines helps to decrease risks of infections.
  • Promptly seek treatment for any concern of an infection.
  • Complete full treatment for infections as prescribed.