When a 16-year-old ace basketball player of DY Patil School ran into a wall and suffered a trivial knee injury, little did anyone suspect that it would result in Tropical Pyomyositis, a rare bacterial infection of the skeletal muscles.
Shreesha Shridhar (in red) with Dr Prakash Jiandani on his right, his parents on the extreme right, Dr Kedar Toraskar (wearing a tie) and a doctor from the team that treated him.
After being told by MGM Hospital, Vashi, that the infection had put Shreesha Shridhar in the jaws of death, and being turned down by Lilavati as well as Bombay Hospital due to unavailability of beds, his parents ultimately found relief in the hands of the director of critical care at Wockhardt Hospital, Dr Prakash Jiandani.
A team of critical care, chest physicians, orthopaedic surgeons and cardiologists performed over 15 surgeries on Shreesha in a matter of two months. Recently, after completing an antibiotics course, Shreesha and his parents, who had lost hope of any recovery, are waiting for him to step onto the basketball court again.
The minor injury was sustained in April. Shreesha ignored it at first, said his father, an investment banker. Looking back, Shridhar R, his father, said that the period was one of the most difficult of their lives as they had been told that Shreesha would not survive the infection if he did not receive the right treatment on time.
“It was a minor knee injury which was, as usual, ignored by him at first. But sudden pain in his left knee was followed by swelling, which spread all over the leg within six days,” said Shridhar. Shreesha said later he started facing difficulty in walking, and breathlessness and fever.
“The worst part of the ordeal was that it started with me not being able to play basketball,” said Shreesha. As his condition started deteriorating, his parents realised that the injury was something major in disguise and went for an MRI, as well as other scans to diagnose the ailment.
MGM Hospital, where Shreesha was taken at first, after investigating the case and reports, revealed that he was suffering from a severe infection which had spread all over his body. “The doctors couldn’t diagnose the ailment but they told us that there was very little chance that he would be able to make it,” added Shridhar. He said, “But we did not lose hope. How could we see our son die in front of us?”A doctor responds
The family then contacted Lilavati and Bombay hospitals, but due to unavailability of beds, both the hospitals informed them that they wouldn’t be able to accommodate Shreesha.
However, a senior doctor from Lilavati referred them to Dr Jiandani, who was previously attached to the hospital and is heading the critical care department of Wockhardt Hospital. “At 1.30 am, I received a call from the father of the patient about the ailment.
I spoke to the treating doctors and realised that the patient’s condition was critical. I told them to bring him to the hospital immediately,” said Jiandani. When brought to the hospital, the week he sustained the injury, Shreesha’s blood pressure was dropping dangerously, his body temperature was low and after several tests, the doctors realised that he was in severe septic shock.
“Initially, we could not believe that what started as leg pain could be so devastating. A provisional diagnosis showed that it was a case of septic arthritis with toxic shock syndrome. The patient had routine blood tests and essential screening to diagnose the exact cause of the disease. His condition had deteriorated, his ability to walk had vanished and he was experiencing severe tremors,” added Dr Jiandani.The diagnosis
As the ailment was diagnosed as Tropical Pyomyositis, a rare infection with only a few sporadic cases found in India, Dr Kedar Toraskar, consultant critical care and chest physician also joined the team treating Shreesha.
While he was shifted to the ICU, where he spent more than two months and the doctors performed over 15 surgeries on him in order to treat the sepsis, doctors struggled to keep Shreesha out of danger.
“This case was quite complicated as the patient had also developed a critical condition of haemorrhagic pleural effusion (abnormal collection of inflammatory cells in lungs) with low WBC count.
We had to treat all the abscesses, which had spread to most of his muscles, surgically,” said Toraskar. Shreesha’s left knee joint was operated on thrice. “The patient had developed multiple abscesses in his hands, muscles and other parts of the body, we had to do operations within a short span.
Along with the knee, several other major surgeries on different parts of the body had to be scheduled to save his life,” said Dr Mudit Khanna, orthopaedic and joint replacement surgeon. Shreesha’s parents say that they had completely given up on their son’s survival chances, but kept encouraging him to fight the disease.
“We thought it would be a miracle if he survived,” said Shridhar. Two months after the surgeries and fifteen days in the general ward, Shreesha was finally sent home in the month of July. While the doctors were delighted to see the results, Shreesha had to continue the antibiotics course that lasted for next one and a half months.
Now that he is able to walk and has started school, his parents are happy that Shreesha has resumed his normal life. But the the most important thing he is looking forward to is getting back to the basketball court.
“I am able to walk normally but the doctors have told me that they will let me know when I can strain my body again to take part in basketball sessions. I am eternally thankful to the doctors and my parents for bringing me back from the jaws of death,” said Shreesha.
Source : Mid-Day, September 2015
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