Baffling medical mystery of the poultry worker who stank for five years

Four doctors in Wales rose to fame because of a man who pricked his finger and smelled putrid for five years.

The doctors were hit nose-on with one of the most baffling medical mysteries on record. It all started with a chicken. The case ended happily – yet mysteriously – half a decade later, the stink having vanished. The Lancet published an account of this called, accurately, A Man Who Pricked His Finger and Smelled Putrid for 5 Years.

The report, written by the relieved but puzzled physicians, ends with a plea: "We ask assistance from colleagues who may have encountered a similar case or for suggestions to relieve this patient's odour."

Here's what happened. In September 1991, a 29-year-old man who dressed chickens for a living cut his finger with a chicken bone. This fateful prick cause his finger to soon become reddish and smelly. The man got himself to the Royal Gwent Hospital, in Newport, Wales, where Drs Caroline Mills, Meirion Llewelyn, David Kelly and Peter Holt took him under their care.

The doctors treated the man with the antibiotic flucloxacillin. His hand still smelled.

Then they tried a different antibiotic, ciprofloxacin. His hand still smelled.

Next came erythromycin. Still his hand smelled.

Next up: metronidazole. The smell persisted.

The doctors delved into the hand surgically, but found nothing there of interest. They did a skin biopsy and cultured the microorganisms from it, hoping to discover some noxious bug. Here, too, they found nothing of interest.

Meanwhile, the man continued to stink.

The doctors took stool cultures. These stank, too, but only in the ordinary way.

The doctors tried everything they could think of: isotretinoin, psoralen, ultraviolet light treatment, colpermin, probanthene, chlorophyll, and even antibiotic withdrawal to allow restoration of normal flora. All to no avail.

As they put it: "Although the clinical appearance improved, the most disabling consequence of the infection was a putrid smell emanating from the affected arm, which could be detected across a large room, and when confined to a smaller examination room became almost intolerable."

After five years the man still stank. The doctors wrote up a description of this curious case, and published it in hopes that some physician somewhere had encountered a similar problem and could suggest a way to relieve the patient's distress.

For treating, and of necessity smelling, the unfortunate man who pricked his finger and smelled putrid for five years, the doctors – together with their unnamed patient – won the 1998 Ig Nobel prize in the field of medicine.

Their acceptance speech spoke of their hope to advance medical knowledge: "We published this case to seek help. Despite enormous amounts of correspondence, nobody had ever seen anything like this before, and no suggestions were effective. Our story, however, does have a happy ending.

Our patient no longer smells putrid. Thank you very much."

• Marc Abrahams is editor of the bimonthly Annals of Improbable Research and organiser of the Ig Nobel prize