Pune: As monsoon revived during the fag-end of September, the parents of a seven-month-old boy suffering from acute dengue were braving the sharp rain taking the infant from one hospital to another for proper medical care. The child had high fever, trouble in breathing and no urine output for a day.
After being turned away by two-three hospitals for lack of paediatric intensive care units (PICU), the parents finally ended up at Sahyadri Hospital in Hadapsar.The infant was immediately admitted into the PICU of the health hub on September 24 under the care of paediatric emergency medicine specialist Dr Ganesh Badge. When nothing worked, the doctor had to resort to treating the infant with chemotherapy medication and it worked.
“In the middle of the night, the infant presented us with cold extremities and low blood pressure. He required oxygen to ease breathing,” Badge said.
The boy was put on saline and inotropes to maintain blood pressure. Inotropes are drugs that tell the heart muscles to beat or contract with more or less power.
“Usually, a dengue patient recovers in 6-7 days. In this case, however, the fever was not coming down even after a week. The test reports to rule out other infections also came negative. We checked for his inflammation markers, which were very high,” Badge said.
The infant had edema (swelling) throughout his body and his spleen was enlarged, while his platelet count was not improving even after the treatment. The treating doctors had almost hit a blank wall on the treatment plan when they turned to hemophagocytic lymphohistiocytosis, which is an investigation of the bone marrow to detect hemophagocytic lymphohistiocytosis (HLH), a syndrome of multiorgan system dysfunction.
“We had to finally resort to etoposide, a medication used in the management and treatment of various cancers. It was only then that we could see slow yet steady recovery. He was discharged on October 21, after four weeks in the PICU,” said Badge.
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