Paulness: From the family history the baby was symptom free until late afternoon yesterday, then developed lethargy and a fever. The baby's condition worsened and the parents got him here at @ 8 PM. Our ER administered Ceftriaxone, a broad spectrum antibiotic often given when sepsis or meningitis is suspected. The child was admittted to Pediatric ICU by 11 PM.
At midnite we started Vancomycin. Shortly thereafter we started Dexamethasone and mannitol to reduce cerebral edema. By the morning the child "coded", and was on life support measures (many IV drips to maintain hemostasis). Antibiotics continued, but to no avail. It had to have been staph or strep meningitis. The source? Who knows. The blood cultures are not back yet, but the Gram stain showed Gram positive cocci. It had to have been bacterial. A viral infection would not have killed so quickly. These virulent bacterial infections can produce a toxin which causes the septic shock and untimately kills the patient. What was striking about this case was the extremely fast progression of the infection. From symptom free to death in 30 hours. That is scary. If I find out the culture results I can provide more info. The case is up for review tomorrow. We (our hospital) went by the book in treatment. Ceftriaxone is standard. The addition of Vancomycin is standard. I'm not sure what else could have been done. You can only pour so much antibiotic into a 3 month old. But what this case illustrates is that we need a more powerful weapon against infections. We feed antibiotics to our livestock, treat relatively mild viral infections with antibiotics, etc...thus leading to the development of "super bugs". Remember the addage..What doesn't kill me makes me stronger. Well that is especially true for pathogens. If you treat them unsuccessfully and they survive they are more virulent. And their offspring get genetically programmed to be more virulent. I hope CYGX puts the anti-staph plasmid on the front burner, ahead of the herpes product. THe need is there. It would be a great development for medicine.
AI
