Age: 0.5
Sex: F
Vaccine: DTAP
Symptoms: Pain, Staring, Stupor, Tremor, Viral infection
Clinical narrative: On 02/20/01, I took the patient to the hospital for a temperature of 103.1. She was showing signs and symptoms of the flu. At this time the flu was really going around. We were at the hospital for approximately five hours. Around the fourth hour, they attempted to take blood, having stuck the needle in both arms moving it up and down and all around; both arms were turning purple from all of their sticking. I told them to forget trying to draw blood because of the fuss the patient was making. She hadn't eaten since we got there, and she was tired. So I told them if she got any worse I would bring her back. They wanted to draw the blood to check and make sure her flu symptoms were just that, and not an infection. They told me just to give her children's Tylenol. So in the three weeks that followed she went through probably three or four bottles of children's Tylenol cold formula. During this same three weeks I got up one morning to find my daughter standing in her bed, with a "lump" on her head. The only way I know to describe the lump is it looked like a "soft golf ball" right between her eyes. When I touched it she showed no sign of pain or discomfort. The lump was not bruised or discolored I assumed maybe that she bumped her head. I took digital photos of her and sent them to my mom and one other. Both replied immediately saying she didn't look like she felt to well, other than that she looked fine. She had a couple spells  of "shaking" in these three weeks also. It to me looked like seizure like episodes. One night she fell asleep in her playpen and I picked her up to carry her to her crib. She was shaking as I carried her. To me it did not seem like she was cold, at least not to the touch. So I attempted to wake her to make sure she was ok. She would not wake up. Normally if you sit her down in front of you and say her name she wake right up. This night should not wake up. I said her name, I tried to tickle her, I tried to rustle her around, and nothing was working. So person said her name aloud and she awoke. She seemed fine, and fell back asleep in my arms. So I carried her to her bed. The following day, she slept literally all day. Around noon or one in the afternoon I called the hospital and informed them of her symptoms and asked if they thought she needed to come in. They blew me off. I think the lady was in a hurry to get off the phone. So I called my mom, and person's mom, they both reassured me that the flu was going around and not to worry. On Saturday, 03/03/01, I had my daughter 1st birthday party at our house. Person's family came up, and my family came down. My stepmother who is a RN said she noticed my daughter having these "staring" spells. She said they are termed medically as Petite Grand Mal Seizures. She didn't seem to have any fun. She did not act like a vibrant one year old. On Sunday, 03/04/01, it was my 1st day to work. My scheduled shift was 6pm-3am. I was getting ready to leave at 5:30 pm and my daughter was fussy and seemed tired so I laid her down for a nap. Person says he woke her between 9:50pm and 10:00pm. He says she was burning up with fever. He says she had vomited her dinner, had a dirty diaper, and was also soaked with sweat. So he wanted to put her in the bathtub and clean her up. He stripped her down and took her to the bathtub. He set her in the empty tub and turned the shower on. Cold water sprayed on her. So person turned it off immediately until it was warm. He then bathed her in warm water. He washed her hair holding her head and neck in his hands, then her body. He says it was only about a ten minute bath. He removed her and wrapped her in a towel. I came up the stairs approximately 10:10pm, on my lunch break. When I walked up the stairs he had her wrapped in a towel holding her close to his chest. Her arms and legs were extended, and she was moaning. I asked him to give her to me. When he turned her around to me, I was floored by how sick she looked. Her eyes were sort of rolling, she was not responding to me. She was awake, just not focusing on anything. I took her directly to my bed and wrapped our comforter around her she was literally freezing. Her feet were a shade of purple and part of one of her arms. I said her name a few times and when she still did not look at me I said were taking this baby to the ER. So I got her dressed really warm and we headed off to the hospital. It is now approx 10:30pm. When we walk thru the door at the ER, I am now frantic wanting to know what is wrong with her. They take her in immediately. She had a temperature of 84 degrees and required, artificial warming, a ventilator, along with intravenous fluids and medications to maintain her blood pressure. They also told me they gave her a "heavy" dose of seizure medication; she appeared to be having one when we brought her in, and also because I described seizure like activity. So the doctor called a hospital and asked for life flight team to come and transport her to their hospital. But because of the snow she had to go by ambulance. They stabilized her and did not transport her to the hospital until approx 2-3 am. There she was taken to peds ICU and was listed in critical condition. She had CT scan and and EEG. They did blood cultures, which all came back negative, although they said it still sounded like a viral infection. And other testing I'm sure. She remained in peds ICU until approx 8 or 9 pm Monday, 03/05/01. In the week that followed she underwent more EEG's, a MRI, and more Blood cultures, and full body x-ray. All of the EEG's were normal, so the thought of being epileptic was ruled out. I was told that sometimes when children get sick and especially with the type of viral infection they suspected she had sometimes they have seizures. They said once the infection was treated and gone, she should not have any more seizure activity. We were in the hospital until 03/11/01. During her stay in the hospital she seemed to be feeling much better. For the 1st time in three weeks her congestion was gone, her nose was no longer running, no more sneezing, and her cough was gone. She still didn't want to eat very much though. She lost three pounds during her week stay. So on the 11th we were released, being told when I originally took her to the 1st hospital she was having a febrile seizure, she had a viral infection, and had acquired anemia. They gave me a prescription for an antibiotic for the infection and and iron supplement for the anemia. After we left the hospital she seemed to be feeling much better. In the weeks that followed she played and ate a little better. She was finally acting like a one year old should act. On Tuesday, 04/17/01, my daughter and I met person at 3:00pm to ride over to the community college to turn in some paper work of mine. We all went in and I turned in the paper work and scheduled testing. We left from there and rode around to look at real estate. It was starting to get dark, and my daughter started getting fussy so we stopped at the store to get a few things real quick. We went in got what we needed and went home. It was dark by the time we got home. I fed my daughter and changed her diaper. Person and I played with her for a little bit then we took her to bed. I laid her down, and gave her a kiss, while person closed her curtains. I turned on her monitor, we told her we loved her and shut the door. The following morning Wednesday, 04/18/01, person and I got up at approx 5 am I fixed him breakfast while he got ready for work. He went on to work at approx 5:45am and I layed back down. At approx 5 minutes after 8am, I heard her 1st cry. Then approx 8:20 am I heard her cry again. Only this cry seemed like a painful cry. I jumped up and ran right in and found her lying in her bed rather than standing. Which was very strange. She is always standing to greet me. So I was wondering immediately what was wrong. I thought maybe she was still tired and possibly didn't feel well. I picked her up and carried her down the stairs. When we got down stairs we did the morning ritual. I changed her diaper, put her her in her little rocking chair, turned Barney on, and gave her some milk. During all of this she was fussy. I went in to make her breakfast. I made her oatmeal, and brought it into the living room to feed her. When I put her in her high chair she didn't want to sit there, nor did she want to eat. So I placed her on my lap and cuddled. About half way through Barney she turned her head away from the TV and wanted me to hold her, while she cried. At approx 10:20am I called my mom in WV concerned for the way she was acting. My mom could hear her in the back round crying, so she told me to give her ten minutes to get dressed and she would be there. It takes her about an hour and a half to get to my house. So I knew it would be about noon when I would see her. I hung up the phone and called person at work. I told him my daughter seemed like she didn't feel well and that my mom was coming to see. I told him I was going to call the doctor and see if he could see her. We hung up and I called he pediatrician. His nurse told me it was his early day and he would be leaving at approx 11:30am. She asked if I could get my daughter there before that and I told her no, my mom wasn't going to be at my house until noon or after. So we agreed if my daughter got any worse I would take her to the hospital. My mom and stepfather got there right about noon. When they got there I went up to take a shower. When I came down from the shower my stepfather had observed her behavior and thought something was wrong with her leg. He said when he straddled her across his lap to play paddy-cake she would cry. So I layed her down on the floor and began playing with each leg. First the right nothing, Then the left and she showed discomfort. I assumed from all the walking we had been doing with her maybe she twisted her ankle. My mom stayed until about 6:00pm. She told me to keep an eye on her leg and foot, and if there was ever any bruising or swelling to take her to the hospital. So I monitored it all evening. She seemed fine. The following morning, Thursday, 04/19/01, she was standing in her bed like normal. We did all the same morning rituals. She ate and played and seemed fine. The same for the following day also. On Saturday, 04/21/01, we had  an appointment to look at some real estate. While we were outside looking at the garage, I attempted to put my daughter down to stand on her own. She fussed when I did this. She was favoring her left leg. I took her to the truck and pilled her pant legs up and noticed the left leg becoming slightly swollen. I called person over to the truck and he took a look. I told him I was calling the doctor first thing Monday and taking her in. The next day, Sunday, 04/22/01, she stood on it a little better, but still I was going to take her. So on Monday, 04/23/01, at approx 9:00am I called the doctors office to see when he could see her. I was told to bring her in at 11:15am. He took a look at her and when he pressed on the bone on the left leg, she showed signs of pain and discomfort. He told me he thought her bone was fractured and to take her to the hospital immediately. So I swung by my house and got person and we were off for the hospital. When we got there they did x-rays of her leg and found a spiral fracture. They put a cast on up her thigh and said it would come off in about a month. The orthopedic doctor said that there was no way she could have this type of fracture in her bed. Which was my only theory. When I put her to bed on the 17th she was fine and when I went in on the 18th she was not standing. Since then the cast has been removed. They say her leg has healed perfectly after only three weeks. She has been placed on high calorie / high protein diet to help her gain weight. She has gain about 4 to 4 1/2 pounds.