Kiss of Death

A CLINICAL PROBLEM-SOLVING article by Brian Graham from University of Colorado Health Sciences Center, Denver.
A 23-year-old South African man presented to an emergency department with a 2-day history of fever, mild dyspnea, headache, nausea, and myalgias. His symptoms had begun 5 days after he had traveled to Colorado to ski with friends. He was thought to have a viral illness, was treated with intravenous fluids, and was discharged with a prescription for acetaminophen–hydrocodone. After 2 days, his symptoms worsened and he returned to the emergency department. A chest radiograph was clear, and he was treated with intravenous fluids and ibuprofen, again without relief. The following day, he returned to the emergency department with vomiting, dyspnea, and photophobia. He was admitted to the hospital for further evaluation and treatment. He was sexually active and had had more than 15 sexual partners in his lifetime. He had traveled extensively the preceding year and had recently driven across South Africa in an uncovered vehicle.
In this patient, disease acquired in Africa as well as more “routine” causes of infection must be considered.
He remained episodically febrile. On day 5 of the patient's hospitalization, the antibiotic regimen was broadened. Liver-function values continued to increase. The patient's mental status declined. He had a generalized tonic–clonic seizure. He was transferred to a tertiary care hospital for further evaluation and possible liver transplantation. Patient's friends revealed that he had left a nightclub with a female companion several days before he became ill.

"kiss of death" というのは、最後の晩餐後、ゲッセマネの祈りを終えたキリストにユダが売り渡す合図のとしての接吻をすることに由来するそうです。「一見ためになるようで実は破滅をもたらすもの」とか、「ありがたくない方面からの（計略的な）候補者支持」、「命取りになるもの」、「災いの元」、「致命傷」などの比喩として使われるようです。
一方、"kiss of life" という表現もあり、イギリス英語で「口移しの人工呼吸」のことで、アメリカ英語のmouth-to-mouth resuscitationのことです。