Day 33 AM: new challenges

We received two pieces of distressing news late last night. First, the preliminary read from the skin biopsy is that the rash is caused by severe graft vs. host disease. This is just preliminary, and we haven't had a report from dermatology yet, so we don't know how sure they are of the result. Second and more urgently, Mina Brigitta has a bacterial infection. The blood culture drawn yesterday morning grew enterocuccus bacteria (http://www.medterms.com/script/main/art.asp?articlekey=20162. It's a classic case where the infection likely came from her bowels and entered her bloodstream through an open sore. She had been on antibiotics to cover against this kind of infection, but they were pulled on Sunday on recommendation from the dermatologist, in case they were contributing to Stevens-Johnson syndrome. The doctors knew there was a strong possibility that this kind of infection could occur, but felt they could take a calculated risk because the "gram positive" bacteria that enter through the skin tend to be slow-growing.

Dr. Horn told us last night that the next 12-24 hours will be critical to see how she responds. She was already showing some signs of sepsis (http://www.medterms.com/script/main/art.asp?articlekey=5449) yesterday, particularly the intestinal bleeding and decreased urine output. She remained very stable throughout the night, even sitting up for an hour or so and interacting. Her fever also diminished during the night and was gone by this morning. However, the bacteria probably hasn't grown to its full potential yet. It helps a lot that Mina Brigitta has a healthy neutrophil count, so she has some ability to fight the infection on her own. Thanks again to everyone for writing in; it really means a lot to know that we have so much support. Please keep us in your thoughts and prayers over the next day or two to help Mina Brigitta clear this infection.