Here’s a precautionary tale about eating leftovers. And ironically it’s from the recent recirculation on social media of a case report that first appeared in the New England Journal of Medicine about a year ago in March 2021. Note that eating leftovers from a year ago is in general a bad, bad idea.
For the case report, several Massachusetts General Hospital (MGH) doctors (Pavan K. Bendapudi, M.D., Michael J. Whalen, M.D., Manuella Lahoud-Rahme, M.D., and Julian A. Villalba, M.D.) detailed what happened to a 19-year-old man after he had eaten rice, chicken, and lo mein leftovers from a restaurant. About 20 hours after this feast, he began developing abdominal pain, nausea, and vomiting. Worsening chills, muscle aches, shortness of breath, headaches, neck stiffness, blurry vision, and weakness followed. He began developing purplish patches on his face, chest, abdomen, arms, and legs, which is not a typical effect of lo mein noodles. Thus, his friend brought him to the emergency room of a hospital. Of note, his friend had eaten from the same noodle stash, had vomited, but didn’t get ill in the same way.
At the hospital, the teen’s shortness of breath grew worse and worse and his blood pressure dropped. As a result, he required oxygen, was given a bunch of medications, and was soon placed on a ventilator. Since this first hospital may not have had all the means to take care of him, doctors put him on a helicopter to be transferred to the pediatric intensive care unit (PICU) of at Massachusetts General Hospital. There he was treated for shock and multiple organ failure.
Blood and urine tests revealed that he was infected with a bad, bad bacteria: Neisseria meningitidis. This bacteria had made its way to his bloodstream, where it was causing all kinds of problems including “purpura fulminans.” If someone tells you that you have purpura fulminans, your response should not be “cool.” Having Purple Rain is one thing. Having purpura fulminans is another and a life-threatening emergency.
Purpura fulminans can develop seven to 10 days after a bacterial infection in your blood when many blood clots form throughout your body. These blood clots can block circulation to different areas of your skin, resulting in purplish areas of skin death that grow in size, forming lesions called purpura. These clots can also block blood circulation to your arms, legs, feet, toes, and fingers, starving them of oxygen and leading to death of their tissue. The clots can cut off blood flow to your major organ as well such as your liver, lungs, heart, and kidneys. Eventually, your entire blood circulatory system can collapse.
Doctors ended up having to amputate different parts of the 19-year-old’s fingers and both of his legs below his knees. Fortunately, he did survive the ordeal and apparently has been recovering from the awful experience.
This video from the Chubbyemu YouTube channel re-enacted what happened and has gotten over 951,000 views so far:
Of course, case reports in medical journals usually cover more unusual or even very rare cases that have severe consequences. Typically, you won’t see a case report of something more common like “hit head while at Harry Styles concert so had to lay down on sofa” or “threw out back while reaching for a French Fry so now making sure French Fries are closer to me.” This 19-year-old’s experience was quite rare. Therefore, whenever someone says, “hey, want to try some leftovers,” you don’t have to say, “what are you trying to do, kill me?”
However, it is a good idea to take some key precautions when handling, storing, and eating leftovers. First, try to keep the leftovers from being contaminated before storing them. If someone says, “these should be OK, since I only sneezed on them twice,” discard the leftovers as soon as possible. Just spend the extra bucks to purchase new food.
Use only clean containers to store food. Keep in mind that anything licked clean is not clean. You are not a cat.
Put the leftovers in the refrigerator or freezer as soon as possible, within two hours of they were first cooked. In other words, don’t wait until after the Lord of the Rings trilogy is finished to clear the table. Wrap your leftovers in packets that are as airtight, small, and clean as possible. Treat bacteria like really strict parents may treat their family members. Do not give bacteria any extra room to breed.
Remember three to four are the magical numbers when it comes to having relatives stay over your place or storing food. Don’t store leftovers for longer than three to four days in the refrigerator or three to four months for the freezer. Similarly, relatives can go bad after three to four days, although your should not store your relatives in either the refrigerator or freezer for any length of time.
Don’t rely on taste and smell to determine whether food is still good. Food can seem perfectly fine yet harbor bad bacteria. Of course, if your leftovers run away from you or argue back, don’t consume them.
Although Khan may have said in the movie Star Trek II: Wrath of Khan that revenge is a dish best served cold, the same thing doesn’t apply to leftovers. Instead, heat leftovers to at least 165°F to kill bacteria like Salmonella. Higher temperatures may be necessary if the food is particularly dense. Make sure every part of the leftover is well heated.
These are some of the good food safety practices that you should employ at all times. Of course, not all contaminated leftovers will leave you hospitalized. You may even get away without having any symptoms. Nonetheless, the MGH case report is a reminder that things can potentially get worse, much worse. So if you are noodling around, wondering whether your leftovers are still good, you may want to just throw them away and start afresh.