Neisseria

I was really looking forward to my Friday night shift because then I would have a nice long weekend without having to work. I got there at around 3pm and just grabbed the first chart I saw. Hmm...9 month old who has nausea and can't open one eye. Sounds okay to me. So I go see him, and he's like, really sick. He was listless but if you disturbed him he would get irritable and cry. One of his eyes wouldn't open and the pupil was really dilated and wouldn't react (get smaller) when a light was shined on it. That's not ever a good sign. I went and grabbed one of the docs and told him what was going on and he went in to take a look at the kid. We spent about 5 minutes in there before he started ordering stat labs, a head CT, and moved the family to a room that could be observed from the main nursing area (for really sick people).

As soon as the CT came back, I got to do a spinal tap on the kid. Those are fun. I've done several of them, but not successfully on a kid that young. I know how bad those hurt, and it's hard not to think about that while you're doing it. He was really squirming around (despite the nurses' strong hold on him) which made me so nervous my hands were shaking. Finally, when I thought I was never going to get there, I felt the needle "pop" into the space the holds the spinal fluid. As soon as I withdrew the needle, the spinal fluid came out through the catheter pretty fast. It was grey and cloudy, which I had never seen before, and it also made the doctor pretty excited. He said it's not something he's seen very often. (spinal fluid, or CSF, is supposed to be clear)As excited as we were, it's a pretty grave finding. It's spinal fluid full of white blood cells, which are only found if there's an infection. As luck would have it, the lab called and said it was Neisseria meningitis, one of the quickest, most deadly kinds, and not very common. All of us that had contact with the kid had to take Cipro for prevention that night and I guess for the next 10 days we need to watch oursleves for symptoms of meningitis. (Gee, wouldn't that suck to come down with meningitis on Valentine's Day, especially since my doctor-boyfriend is out of town until Thursday). The baby was transferred to ICU, and hopefully he is alive today. None of the doctors were too hopeful he would live through the weekend.

When I go in tonight, I'm going to go up to the PICU and see if he's still there. I really hope he is. I'm just left wondering where this baby picked up that bacteria. He doesn't go to daycare, but yet he got if from somewhere. I guess that will be up to the health department to figure out.