~ The coroner said the case was outside his responsibility, and the family declined an offer from the hospital.

Cape Girardeau County Coroner John Clifton says it's not his job to try to determine the cause of death of a 23-year-old Southeast Missouri State University graduate student who died suddenly Tuesday after experiencing flu-like symptoms over the weekend.

"It is just a medical curiosity," Clifton said. "It's not anything that the coroner's office would be involved in."

Angela Hotop of Perryville, Mo., died Tuesday at Saint Francis Medical Center from a fast-acting infection doctors couldn't pinpoint. She was admitted to the Cape Girardeau hospital on Saturday night after a day of fever, diarrhea and vomiting. By Sunday night she was unconscious, family members and friends said. She died two days later.

Neither the hospital nor the doctor can talk about the case, said Barbara Thompson, vice president of marketing and public relations at the medical center. She said federal law prohibits hospitals and doctors from revealing information to the public or news media about any patient.

Family members said the medical staff worked hard to save Hotop's life. Doctors treated her with antibiotics even as they tried to detect the cause, members of Hotop's family said.

"They tested her for everything," said her aunt, Carol Buchheit of Perryville.

Doctors believe that Hotop died of a bacterial infection in the bloodstream, Buchheit said.

The hospital offered to do an autopsy, but the family refused to grant permission, said Hotop's father, David.

The attending physician -- whose name hasn't been disclosed -- indicated that an autopsy wouldn't necessarily identify the infection and that the cause of death may never be known, he said.

Still, an autopsy might have revealed the cause of death, Clifton said. Hospitals routinely do autopsies when patients die in their care and the cause is unknown, he said.

Such autopsies can only be performed with the permission of the victim's family or by court order, he said. That's in contrast to cases involving murder or traumatic death, where the coroner can order an autopsy.

Doctors, who had ruled out such things as meningitis, hepatitis and avian flu, said the mystery illness wasn't contagious, David Hotop said. His daughter wasn't quarantined, and family members were allowed in and out of the hospital room.

Cape Girardeau County public health director Charlotte Craig said hospitals must report cases of communicable diseases to the public health department, which hasn't received such a report. As a result, she doesn't believe Hotop's death resulted from a contagious disease.

"I am curious. I am not concerned," Craig said.

But without a definitive cause of death, Clifton questioned how doctors could say with certainty that the deadly disease wasn't contagious.

Judy St. John, director of the center for health and counseling at Southeast Missouri State University, said medical center officials haven't disclosed any information to her on the student's death. "We really are in the dark," she said.

Funeral director John Young of Young and Sons Funeral Home in Perryville said no cause of death has been listed yet on the death certificate.

The doctor is waiting on the results of some lab work that might shed light on the infection, family members said.

Grieving family members said they still desire to find out what killed Angela Hotop.

Said David Hotop, "We would just like to know."

mbliss@semissourian.com

335-6611, extension 123