Need help w/peritonits &/or fungal infection info or experience

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gijanet

Well-known member
Joined
May 18, 2004
Messages
1,767
Location
Arlington, Tx.
Hi, gang! Sorry this is long, but I really need some info for another heart mom of a little one with CHD and thought you guys might be able to help.

Rhonda's one year old daughter Chloe has very, very similar anatomy to Katie's (except her AV valve doesn't leak) and she also has a hypoplastic left ventricle, but this little girl has had a really tough time. I know we haven't had a cakewalk with Katie, but poor Chloe has had to have surgery about every three months from the Norwood to another BT shunt(because they couldn't do the glenn, although that was the game plan) to the Ladd's procedure (surgery to correct a malrotation of the bowel - our kids' stomachs are on the right)to another emergency intestinal surgery due to complications from the ladd's.................this little girl has been through the meatgrinder
and so has her mom Rhonda.

Chloe finally had her glenn (heart surgery rewiring the top half of her body's blood flow) last Saturday and she miraculously sailed through..........very unusual for Chloe, let me tell you. Soooooooo, by Monday she was back in the operating room due to a perforation in her intestines again (just had one last March)............a hole the size of a nickel . Chloe only weighs about 14 pounds, so this was no small hole. Thank God they were able to avoid a colostomy and she seems to be stable at this point............but now she has peritonitis and a possible fungal infection.

Rhonda is desperately wanting to talk to anyone with info on, or experience with, either one of these. I have to work tomorrow, so it will be late afternoon before I can check for responses, but if you will post me or PM me, I will pass on Rhonda's email addy to you so that you can relay any info that you might have.

Also, your prayers would be greatly appreciated as they are not out of
the woods yet. Thanks so very much. Janet Below is part of Rhonda's last
post. P.S. They live in Washington, but go to California for surgeries (Stanford, I think, wherever Dr. Reddy is); thus, they are separated from their six other kids pretty frequently, so prayers for the entire family would be great, too.

Part of Rhonda's last post:

Well we're doing a little better, but she's still seems out of it to
me. Not much fiest in her fiestiness. Concerns me. But I'll give it a
few days to see if maybe it's the infection/peritonitis causing the low
level of responsiveness. I met someone today who got a perforated bowel
during a colonoscopy, and she said she got a bad fungal infection as
well, and now I'm real worried, cause Chloe has a ton of fungal looking
urine in her foley. Do you think you could check with your group to see
if anyone else has any personal experience with peritonitis and fungal
infection? It's kind of funny though cause the heart docs were saying
to me she must have had the perforation before surgery, cause there was
a lot of this fibrogenic material all over her intestines and abdominal
cavity that made it look like it was an older hole. The GI surgeon said
like 2-5 days old. There is absolutely no way she could have had this
prior to the surgery. She was totally fine, absolutely wonderful at
times. (which made it even harder to go through with the Glen in the
first place) Anyways, her vitals are more stable now even if she does
look like a Mack truck ran over her. I'll keep in touch, but if you
could ask about that peritonitis, it would be so much appreciated. Lots of
love
--
Rhonda, mom to Megan 19, Micah and Derek 16, Taylor 7, stepmom to Nick
14, and Cory 12 (all HH) and Chloe 1 year, with complete avsd, dorv,
hlv, coarctation, situs ambiguous/heterotaxy/polysleenia, interupted
inferior vena cava, and malrotated bowel,post Norwood on June 11 2003,
BT shunt November 2003, malrotation repair march 11 2004 and again march
18 2004.

Take care and God bless..................
 
You didn't say whether the girl was on Coumadin or not.

The only thing I know about fungal infections is that some Fungal Medications can affect INR, especially the more powerful ones. An adjustment in Coumadin dosing may be necessary.

'AL'
 
I don't know anything about Chloe's condition, but I will pray for her and her family.
Love,
Mary
 
Thank you for the prayers.

Thank you for the prayers.

I seem to be completely striking out on finding anyone who has experience with either one of these two illnesses. (And no, Al, she is not on Coumadin, but thanks for asking. I probably would not have thought to include that.) Your prayers are certainly appreciated, though, as things have not improved any. They have poor Chloe on some potent IV antibiotics, but her WBC is still climbing and they don't know why. She is still intubated as well. So please keep those prayers coming and thanks again.
 
Sounds more like a hospital infection to me. I hope they have a good infectious disease Doc checking up on this. Will never know where it originated, but she needs the attention of an antibiotic juggler such as Infectious Disease.

Prayers go out on my end also. ;)
 
Prayers still needed..........

Prayers still needed..........

Thanks, Ross! I just passed on that information to Rhonda. Hopefully, they can get some answers soon. Unfortunately, Chloe's condition is still deteriorating. She is still intubated, and her heart rate has dropped down into the sixties (remember, she is only one year old) and is now pacer dependent on top of everything else. No one seems to be able to give Rhonda any answers as to what might be going on. Her electrolytes came back fine. They did finally order a culture, so hopefully that will provide some insight or at least rule something out. In the meantime, please keep those prayers flowing for this little girl...........and her mom and dad who are both physically exhausted and emotionally drained. Much love. J.
 
When I surgery, I got a Staph infection off of an IV line. I had hit 106F and the call was made that they didn't think I'd make it. They didn't know what was wrong either. They got our local Infectious Disease Doc on the case and he picked it off right away. He had them pull the line, made darn sure everyone of them was washing their hands before and after treating me, had me in an isolation room and on so many antibiotics that you wouldn't think a person could survive. I owe my life to the man.
 
Things are still not looking good.....

Things are still not looking good.....

So, thanks, Ross, for sharing this. I am going to pass this on to Rhonda because they did do a culture, but it came back with a really bizarre finding. To quote from Rhonda, it was "... one which grew out a really rare bug, called gram + bacillus (sp) that they had to send to the 'county' because they couldn't rule out anthrax... yes, that's what I said. Anthrax!!! ...... Just too weird. Her heart rate is ok for now, but during the night it dropped into the 40's... yes the 40's. I don't care if they're not worried, I'm not taking her home with a HR of 40. No way! No how! She's still hooked to the pacer, but she's pacing herself right at the moment at about 95-100. So for now I think we're on track, but I just get so worried about everything."

Rhonda did report a bit of good news. Chloe was finally extubated today, so at least something is going in their favor.

Well, thanks again for the info, and do please keep the prayers coming.
 
Sometimes it takes a while (days to a week or more) for an infant's immune system to get up on top of an infection like that. The antibiotic therapy is generally fine-tuned to attack exactly what infections an infant might have (that's what the ID doc is there for) and it just takes some time for everything to kind of right itself. Getting off the vent is a very good sign. They'll need to be extremely careful not to upset the balance she has right now over the infections running through her system but every day she's fighting she should be a little better off as long as there aren't set-backs...


There are times when you just have to let such infections take their course, fighting hard with antibiotics and other tactics, but in the end it's the patient's own resources that will decide what the outcome will be.

That's pretty hard to take at times, but it's one of the upper limits of medical science these days.

Here's hoping this little girl's got a whole hell of a lot of fight in her still.
 
Janet,
I'm afraid i have nothing constructive to add as i've not heard of that before! But as another CHD mum - AND mum of a Chloe!, i can really sympathise and will be thinking about them, hoping they get a correct diagnosis soon and hoping Chloe recovers even sooner!

Love Emma
xxx
 
Feeling pretty helpless............

Feeling pretty helpless............

Thank you all so much for the prayers and info. Poor Chloe is still on that roller coaster. Her heart dipped down into the forties a couple of nights ago; now she is pacing herself at 90-100, which is good, but her WBC and CRP are back up (dunno what CRP is, but I know the White cell count going back up is not good.) She has an infection somewhere that they are not catching, although they have done lots of cultures. (Ross, what line of yours was infected. I forwarded your info to Rhonda, but I don't know if it registered. I know I tend to be really skitzy when Katie is in the hospital.) Rhonda asked me about NEC (necrotizing enterocolitis). I told her what I knew from Katie's experience with it, and then I did some research for her on it, which I just sent her. It's scary - I think Rhonda may be right and Chloe may have NEC - how they wouldn't have caught it when they operated on her bowel, I don't know. I haven't personally seen a necrotized bowel firsthand, but it seems to me that a GI surgeon should recognize it and should have questioned why Chloe's bowel was perforated to begin with............having NEC would explain it based on the research I just did. Anyway, I know you guys are busy, but please take a few minutes to pray for Chloe and Rhonda and please ask for more prayers from anyone willing to give them. Much love. J. Below is
Rhonda's last post - part of it anyway.

"Just a quick question for you. What symptoms did Katie have with NEC?
I just wonder if Chloe may have this. She's passing black tarry stools
several times a day. She's still got tons of green bile coming out of
the NG. It's not to suction, but to gravity. So her new problem is her
WBC and CRP. They're both up again today. The orginial cultures came
back neg. No anthrax...duh!!!...........and her WBC and CRP were coming
down yesterday until today. So today they've drawn more cultures from
all her lines, and another urine culture. She's also got thrush so her
mouth is tender. She won't suck on her binky. Her HR is good. It came
up on its own early yesterday morning. Oh yeah, they're also pulling
her RA line and her last chest tube today, as they think the infection
could be from one of the lines. Anyways, if you can tell me anything
you know about the NEC, I'd love it. Tomorrow they plan to torture her
by doing an upper GI series so maybe we'll know more about the reason
her gut won't digest the bile. I'll talk to you again soon. Lots of
love. Rhonda"
 
I'm spitting mad, Ross!

I'm spitting mad, Ross!

Apparently, Rhonda was paying attention to your info I passed on to her, as she requested days ago that the ID folks get involved..............well, the PICU folks just decided to get them involved today!!!! YOu would not believe what this poor family and little girl has been subjected to over the last few days. I have pasted in below part of her very long post. Warning: It will make you fighting mad. I am mad and frustrated for them, and in the meantime, Chloe is getting worse and losing weight. Please, please keep them in your prayers. Hugs. J.

Subject: Re: Worried - Sorry

Heeeey! I wish I could tell you that no news was good news, but it's not. Unfortunately, I really honestly feel like strangling a few people (mainly the staff here). I'm so at my wits' end, and I'm on the verge of insisting that they transfer her to a hospital that has the capacity to provide the quality care my Chloe deserves. My husband and I have decided (well maybe I decided) that we're not coming back here for anymore surgeries. If at some point she needs the fontan, it will have to be done in Seattle. I guess I'm just going to take my chances. It's unfortunate, but this place has some serious out-growth problems. They've outgrown the building and services. You know how we've been bumped numerous times for the cath, the surgery, and any/all the different types of procedures, consultations, etc. Well, today she's been bumped for a trip to the interventional radiology department for a PICC line placement, which she needs soooooooo desperately. She's had 4 iv's that have gone bad since yesterday, and we're waiting to pull her NG tube and feeds until she gets the picc, but as luck would have it, she's been bumped until tomorrow. So they started another IV for her antibiotics and TPN and lipids. Of course, she was supposed to go at noon today, but we didn't find out she was NOT going until 5:30 this evening, when all the docs and the management have gone home. Oh, I'm so PISSED. I don't think I can get more pissed off. I told the unit supervisor, (she just happened to still be there)that if they couldn't get her in first thing in the morning, that they just needed to transfer her to Seattle where they can obviously provide her with as good of care as she's receiving here, maybe better.

Oh I wish I could tell you good news. The infection is still unidentified and I still don't know any more answers today than I knew 3 days ago. So far the tests have all come back normal or neg. they've done CT scan, an US and many x-rays but still no answer. Do you think they would have called the infectious disease doctors in last week when I requested it, Oh nooooooooooooooooo, they just decided today to call them in. Then the ID docs came by today at noon, and gathered a boatload of info. from her chart, etc. and they told me they were going to review her CT scans and then they'd come back and make their recommendations to the surgeons, but at 6:00pm they show up and say "we haven't seen her CT scan yet and we won't be able to do it today, but we think we will probably plan to change her antibiotics." So, my daughter is most likely on the wrong abo's but they can't change them until tomorrow. Am I just being overly sensitive or is this just down right wrong? What kinda care is this? I just don't know what to do, but I know something better change real soon, or I'm seriously going to blow a gasket, and it ain't going to be pretty. I'm positive they will need to call security. Anyways, thanks for letting me chew your computer ear off. Oh, and to make things even more fun, my sister isn't able to keep my kids anymore because she's got 2 jobs and can't juggle my kids to fit her schedule, so my dad is on his way from Seattle to bring my kids to me. (Well only 2 of them, the others are at various other places)but my 7 y/o and 14y/o are coming. My dad called and said they were staying the night in Yreka Ca. and would be here at the hospital by 2:00 tomorrow. Yea!!! but really, I am kind of excited to see my baby boy, but what am I going to do with him all day long, when I need to be at the hospital babysitting the stupid staff and doctors? Maybe once I turn him loose in the unit, they'll get Chloe well real fast. Anyways, so this is why I haven't been able to get to a computer and check messages. sigh..... I'll update ya soon. Lots of love
--
Rhonda, mom to Megan 19, Micah and Derek 17, Taylor 7, stepmom to Nick 14, and Cory 12 (all HH) and Chloe 14months, with complete avsd, dorv, hlv, coarctation, situs ambiguous/heterotaxy/polysleenia, interupted inferior vena cava, and malrotated bowel,post Norwood on June 11 2003, BT shunt November 2003, malrotation repair march 11 2004 and again march 18 2004.
 
All I Can Do For You Is Pray And That I Will Do In Fact My Whole Family Will Be Praying We All Believe That The Prayers From My Friends Here Are Part Of Why I Am Alive Today.
Lettitia
 
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