Communication and teamwork made a life-saving difference for a patient suffering from one of the most severe cases of malaria ever treated in a Houston Methodist hospital.
In early August, the 64-year-old man had traveled with members of his church to a small town in Uganda on a 10-day mission trip, where he contracted the disease. His symptoms began a week or so after he returned, and he was rushed to Houston Methodist Sugar Land Hospital on Aug. 25.
“We could see immediately that he was very sick,” said Ranganath Kandala, M.D., Houston Methodist Sugar Land hospitalist who coordinated the patient’s care. “His mental facilities were severely impaired, and he was amid multi-organ failure.”
A quick blood test, expedited by pathology, showed that 60% of the patient’s red blood cells were infected with malaria parasites. A 5% infection rate is considered life-threatening.
“The mortality rate of patients with his level of infection is extremely high,” said Kandala.
In the US, only about 300 cases of severe malaria are seen each year. Not every case would be transferred but because these cases are so rare, a patient with a malaria infection above 5% typically would be transferred to the Houston Methodist Hospital in the medical center. But because there were no available beds, the patient was admitted into the Houston Methodist Sugar Land Intensive Care Unit (ICU).
Kandala’s next step was contacting infectious disease specialist Farheen Tariq, M.D., in the middle of the night to request assistance. Tariq quickly called the Centers for Disease Control and Prevention (CDC) to obtain the anti-malaria medication, artesunate, which is not stocked in pharmacies.
“We were fortunate that the CDC now stores artesunate at its quarantine stations, and there is one in Houston,” said Tariq. “That enabled us to get the drug in a timely manner and begin intravenous treatments.”
In addition to doses of artesunate, the patient also required a red cell exchange to remove infected blood cells, a procedure that is rarely performed at Houston Methodist Sugar Land before. Each cycle of the exchange had to be timed around the doses of artesunate for maximum effectiveness.
Despite the patient’s severe condition, the treatment began making a difference almost immediately. Within four days, the patient’s blood cell infection rate was down to 0.5%, and he left the hospital on Aug. 31.
“We had fantastic coordination between our team here, everyone in the ICU, the coordination with the pharmacy team, the CDC and the staff at Houston Methodist in the medical center made sure we were moving as quickly as possible to save this man’s life,” said Tariq.
Also assisting on the case were intensivists Kabir Rezvankhoo, M.D., Munish Lapsia, M.D., and nephrologist Sachin Soni, M.D. It was a true team effort.
When the patient was discharged, his family broke down in tears.
“It was a very unique moment, one that had to be experienced to fully appreciate,” Kandala recalled. “Their family member was so close to death, and just a few days later, they watched him walk out healthy. They were extremely grateful for the care he received. It was a great day for them and Houston Methodist Sugar Land.”
Jennie Sime says
I am the patient’s wife. We would not have had this outcome had it not been for the team of doctors and nurses and staff that cared for my husband. Every single person we came in contact with was dedicated to his care and treated us with compassion. They cried with us and laughed with us. We really felt like his team of doctors and nurses were part of our family. We will never be able to expressed our gratitude enough for their dedication to making Bob well. Thank you Team Bob for EVERYTHING you did for our family. We love you guys!
Carolyn A Thomas says
This is a personal friend of mine and I know that the family is incredibly grateful for the wonderful care that he received. This man has been on numerous mission trips with our church and this has never happened to him. I have to give God credit along with the great staff here at MSLH. A message for prayer request was sent out to our entire congregation and there were so many prayers given to God for this special man. I know God answered our prayers when our friend was able to go home and resume his life with his family. He was in church the following Sunday after his release from the hospital. God is good!