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A Long Road to Recovery

South Valley boy puts up strong fight against illness caused by inhaling airborne spores of dirt-dwelling fungus

12/1/2011 

Kaden Watson’s family often refers to him as the “social one.” So when the lively 6-year-old boy from Visalia didn’t do his characteristic “funny dance” after leaving church one Sunday and seemed consistently tired after school, it became apparent something was wrong.

Kaden plays with dinosaursWhat Kaden’s family didn’t know was that he had contracted valley fever, a flu-like and potentially deadly illness caused by inhaling airborne spores of a dirt-dwelling fungus. Endemic to our region, especially the South Valley, the hard-to-detect disease enveloped Kaden’s chest so severely that at one point his trachea narrowed to only 4 mm.

“Essentially Kaden was breathing through an opening the size of a straw,” said Dr. James McCarty, a pediatric infectious disease specialist at Children’s Hospital Central California who has 25 years’ experience treating valley fever in children. “Kaden had the worst case of mediastinitis (tissue inflammation in the mid-chest) that I’ve seen. We were very concerned for him.”

Family desperate for answers

Kaden began not feeling well last January, at the height of the flu season. At first it seemed he had typical pneumonia symptoms – a persistent cough, congestion and watery eyes that eventually included a fever, vomiting and night sweats. But even after his local pediatrician prescribed two rounds of oral antibiotics, his health unfortunately seemed to be getting worse, not better. A mass the size of a golf ball also developed at the base of his neck on the right side.

Desperate for answers, Kaden’s parents, Kandis and Phillip Watson, brought their little boy to Children’s Hospital in mid-February. “We wanted someone to tell us what was going on with our son,” said Kandis. “We just wanted him to be well again.”

Kaden smilesUpon seeing Kaden’s symptoms and results from CT and ultrasound scans, Dr. McCarty suspected valley fever, which a blood test confirmed. Kaden was admitted to Children’s.

Caregivers started aggressive treatment. To alleviate symptoms of the disease and ease Kaden’s restricted breathing, they administered antifungal medication and steroids to shrink the inflammation in his chest and lymph nodes. He was transferred to the pediatric intensive care unit (PICU) for closer monitoring.

“Kaden was very ill – his face looked so sucked in, pale, and he had this horrible cough,” recalled Kandis. “We were very scared for his life. It was really tough at the beginning. We didn’t know what to expect.”
“Dr. McCarty told me he stayed up all night worrying about Kaden,” she continued. “It made me feel great as a parent, that he cared so much.”

The combination of therapies worked, and Kaden became well enough to move from the PICU back to the floor. The high-quality care he received in the PICU was crucial to Kaden’s improvement. “They helped keep him alive,” said Dr. McCarty.

Recovery in sight

But as often the case with valley fever, Kaden’s road to recovery would be long. “What I tell patient families is that they can’t think in terms of days and weeks, but in weeks and months,” said Dr. McCarty. “It’s a very stubborn disease.”

“I hated hearing that, but I really appreciated Dr. McCarty’s honesty,” said Kandis. “He didn’t sugarcoat anything – he just told us the truth. He didn’t want to give us false hope. We knew Kaden could get very sick before he got better.”

Kaden remained hospitalized at Children’s for six months, including another round in the PICU when his condition escalated again. “I remember just praying all the time, hoping one day everything would get better for him,” said Kandis.

The Watson family’s wish was answered. Kaden could finally go home. “I’m so excited,” said Kaden, the day before being discharged from the Hospital. “I’ll get to go with my mom and dad, and sleep in my own bed.”

Kaden smilesThe ordeal hadn’t been easy – on Kaden or his family. Kandis needed to quit her job to stay with her son at the Hospital, and she required assistance to help care for her other two young children.

“I was really impressed by this family, how they pulled together and stayed so strong,” said Dr. McCarty. “They relied heavily on their faith.”

“It was hard but we did it,” said Kandis. “Everyone at Children’s helped make it easier.”

Kandis noticed how Kaden grew from the experience as well. “He never complained once, about anything,” she said. “He’s only 6 but I see how he’s matured through this.”

Based on his experience, Kaden had a suggestion for other ill children. “Stay strong, take your medication and get healthy,” said the youngster. He added how much he liked Dr. McCarty because he’s “so smart and tall.”

But while Kaden’s condition has greatly improved, some fungus still remains in his chest. With assistance from home care services, he’ll continue to receive medication to treat the disease probably for the next two years. In addition to seeing Dr. McCarty, he will also receive follow-up care with pediatric nephrology and pediatric endocrinology specialists at Children’s to address effects from his treatment.

“Kaden looks much better and has more energy,” said Kandis. “And the growth on his neck is nearly gone. I know Dr. McCarty wouldn’t allow him to go home unless he’s ready. I’m just sooo glad he’s ready. Thankfully the worst is over.”

 

 

 

 

 

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Valley Fever Facts

Late summer through early fall peak period for infection of valley fever

Valley fever is primarily caused by a fungus called Coccidioides immitis, most commonly found in the deserts of the southwestern United States and Central and South America. The disease spreads through spores in the air when contaminated soil is disturbed such as by construction, dust storms and earthquakes.

The especially dry season late summer through fall is a peak period when adults and children may become infected. Researchers notice that the infection period can be worse in years with heavy winter rainfall. However, the disease may not manifest until months after a person is infected.

“The best thing people can do is avoid inhaling excessive amounts of dust – especially in the South Valley,” advised Dr. James McCarty, a pediatric infectious disease specialist at Children’s Hospital Central California.

Valley fever can be difficult to diagnose, but early treatment is critical to preventing dangerous progression of the illness. Dr. McCarty recommends families and doctors suspect valley fever particularly if:

  • The child has pneumonia
  • The child has symptoms that can’t be explained or persist without improvement

When valley fever is suspected, a doctor can order an antibody blood test or culture. There is no vaccine to prevent valley fever but efforts are ongoing to develop one. Treatment usually includes oral or injected antifungal medicine. Treatment can range from three to six months or years for more serious cases.

This past year, Children’s Hospital, along with other areas of the Valley, has seen a significant increase in the number and severity of valley fever cases. Many of our patients admitted to Children’s for serious infection are under age 4 and mostly come from areas south of Fresno.

Valley fever is an illness that usually affects the lungs. Sometimes other parts of the body are impacted, such as the brain, bone, skin and other organs. This is called disseminated valley fever. Without proper treatment, the disease can lead to severe pneumonia, meningitis and even death.

People at risk for severe valley fever include:

  • Those with weakened immune systems
  • Persons of African or Filipino descent
  • Women in the third trimester of pregnancy

About 60 percent of those infected never show symptoms. The others develop the following ailments that can last a month:

  • Cough
  • Fever
  • Chest pain
  • Headache
  • Muscle aches
  • Fatigue
  • Rash