Sepsis

The sickest patient on our service is a 21 year old woman who had delivered at home.  She came to the hospital with a severe infection that initially we thought was inside her uterus and extending into her bloodstream, otherwise known as puerperal sepsis.  Later in the day her status deteriorated and we admitted her to the ICU, and before the day had ended we had to sedate her and put her on a ventilator.
We were treating her with potent antibiotics and treated her for malaria, but she was not improving.  Her fever was very high and she was developing other complications.  The medical student that we have overseeing her care is named Carolyne (pictured here on the phone in the ICU talking with radiology).

Yesterday morning on rounds our patient opened her eyes when we said her name and began gesturing that she wanted to have some of her tubes removed from her mouth and nose.  Although she was restrained, she was able to reach up and grab her endotracheal tube and pull it out of her mouth.  

As the tube was removed she also vomited, and this ascaris worm came up.  This worm is about 5 inches long, and can cause all kinds of problems with patient management.

Please be praying for this very sick woman.  She has so many things wrong with her, and she still is in critical condition.  Her baby, fortunately, is doing very well in the nursery.  Please pray for her doctors, that we would have wisdom and clarity of insight as we treat the many problems that she has.  I am grateful for the devoted students that I have the opportunity to teach while I am here, and am very grateful to the dedication that Carolyn has shown to her patient.