Saturday, September 3, 2011

Beautiful Babies and Parasite Paradise

The last few weeks have been busy at the hospital, as more people have been trying to get in for their regular check-ups before school starts.  Many new babies have been brought into the world as well.  Dr. Egberth and I performed a c-section on a mom with double-breech twins.  Everyone did great, and it was really fun to be involved with this family's excitement (even if she did need her surgery emergently at 3 am).  We had another mom who came in with her baby in the transverse position.  Working together, we managed to help that baby do several summersaults before she finally settled into a head-down position.  At that point, we broke the mom's water and induced the labor, hoping to keep the baby aimed in the right direction.  Unfortunately, the rascal switched back to transverse, and we ended up performing a c-section after all.
10.5 pounds of joy
We at Hospital Vozandes aren't the only ones who have been busy lately.  Apparently the worms in the jungle are also prospering and expanding their horizons.  Last weekend I took care of three babies in room 8 of our hospital.  One of the babies had Rotavirus (a virus that makes the patient have bad diarrhea) that had caused dehydration.  Another had been sick with a fever for weeks.  We ruled out the most common infections (malaria, dengue fever, tuberculosis and leptospirosis) and settled on a diagnosis of "Jungle Fever."  Patients like him come to our hospital every now and then, and we usually give them a kaleidoscope of antibiotics to cover oddities like brucellosis and Q fever.  The third baby presented with extreme weakness and pallor.  His hemoglobin, which is a measure of red blood cells, had dropped to 2 (normal for his age would be about 10-13).  He was diagnosed with severe anemia, which had evidently developed over several weeks.  Dropping a person's hemoglobin down to 2 acutely would cause shock and death, but the body can often make compensations if it is a gradual process.

The anemic baby was found to have an infestation of hookworms.  This parasite can burr through the skin of the feet to enter the bloodstream.  It's next stop is the lungs.  From the lungs, it climbs up into the throat and jumps down into the esophagus, with the goal of setting up a new home in the duodenum of the small intestine.  There, it attaches to the wall and drinks blood to its heart's content.  Our anemic baby with the hookworm infection quickly got better with a blood transfusion and anti-parasite drugs.  The other babies were also getting better, but their moms were concerned that they had persistently-bloated bellies and poor appetites.  We also treated them for parasites, and many interesting things were found in their diapers over the next few days.  In the end, all of them got much better and were taken home by their happy mothers.

Looking better after getting rid of Rotavirus and other critters
Addition of blood and subtraction of hookworms equals a fat, happy baby
After successful treatment of "Jungle Fever"
 (All pictures taken and posted with permission of the patients and their families)

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