Karen Root’s sleuth skills literally prevented a 1 pound, 5 ounce baby from dying of fungal sepsis.
Baby D, born at just 24 weeks gestation, was admitted to the UVA NICU after being delivered secondary to preterm labor. Baby D was immediately started on IV antibiotics because infection is a frequent cause of preterm labor and is the number one cause of death in preemies. Despite antibiotic treatment, Baby D continued to clinically deteriorate, developing the highest white blood cell count many of us have ever seen in our careers. We were suspicious of sepsis and meningitis, but the baby's blood culture remained negative. The baby's leukocytosis was so severe, it prompted us to consult the pediatric hematology/oncology service to look for uncommon causes of elevated white blood cells, or "zebras" as we call rarer illnesses.
After sending many labs and other studies to rule out uncommon causes of leukocytosis, Karen instinctively knew that we were missing something and was determined to find answers. Karen carefully examined Baby D's mother's medical record for clues and found that the mother's placenta was positive for Candida, a species of fungus. The result of the mother's Candida positive placenta was not communicated to the medical team taking care of the infant. While fungal sepsis is rare, it carries the highest risk of morbidity and poorest neurodevelopmental outcomes of any infection. Survival depends on quick identification and treatment with IV antifungal agents. Infants are not routinely placed on treatment doses of antifungal medications and fungus is not susceptible to antibiotics. After Karen's important discovery, she was able to promptly order the antifungal medication that saved this precious preemie's life. As of this writing, the baby is substantially improved due to Karen's diligence.
There is no life more deserving of our best efforts that a tiny, fragile baby, and no person more deserving of an award than a person directly responsible for saving that baby's life. Karen is a true DAISY Nurse.