Infection Control Integrates Multiple Departments
As more people travel to Third World countries, it’s even more critical PCPs stay alert to the potential for less common infections to present in their Midwest patients. Beth Henry, MD, infectious disease physician with Infectious Disease Associates of KC, cautions that elusive fevers in returning travelers are cause for further investigation.
“There are many devastating illnesses that present with persistent fevers. When evaluating a returning traveler, take into consideration where they traveled and to what they may have been exposed.”
Although it’s located in the heart of the country, North Kansas City Hospital usually treats a few malaria cases each year. Severe malaria can cause cardiac issues, shortness of breath and brain swelling, with the most severe cases resulting in central nervous system impairment. Because the parasite destroys red blood cells and causes hemoglobin to plummet rapidly, cardiac patients are at a higher risk of a heart event due to the rapid onset of anemia.
Dr. Henry’s most recent case involved a patient who returned from a mission to Uganda. He did not present with typical malaria symptoms or typical lab abnormalities. He was transferred to NKCH from a rural hospital, and Dr. Henry and her team tested for several possible scenarios before ultimately diagnosing malaria. The pathology report listed 10% parasitemia. Because of the patient’s cardiac comorbidities and the “high” parasitemia, CDC guidelines were met for treatment with Artesunate, an investigational drug.
The infectious disease team at NKCH worked quickly to secure emergency legal approval for the import and administration of Artesunate. The process required CDC approval for the release of the drug, shipment of it by air to Kansas City International Airport, secure ground transportation to NKCH, pharmacy and patient approval, and treatment. The path from diagnosis to treatment took less than 24 hours. Artesunate works fast, and by the second day the parasite was eradicated and the patient eventually recovered fully.
Dr. Henry and Mary O’Connor, MD, share coverage at NKCH and acknowledged the integral role that cooperation between departments - including microbiology, pathology, legal, pharmacy, hospitalists, pulmonary and nursing - played in saving the patient.
Beth Henry, MD
Dr. Henry received her medical training at the University of Arkansas School of Medicine. She completed an internal medicine residency and infectious disease fellowship at the University of Missouri, Columbia.