Case Study

Nattakamon

Nattakamon (“Beer”) is an only child who lives with her grandparents in the Sa Kaeo province of Thailand. Her parents work near Bangkok, a nine hour drive away, to earn money for their family. At four months old, Beer became ill and her grandmother took her to a community hospital, where she was admitted.

Within the first week of her stay, Beer experienced a seizure and high fever, and her condition did not improve despite the frequent treatment she was given, so she was referred to the provincial hospital 31 km away from her home town.

At the provincial hospital, Beer slipped into a coma for four days, developed conjunctivitis and a prolonged fever, and was eventually diagnosed with pneumococcal meningitis. Her grandmother was very worried and upset – the doctor told her that there was a chance that Beer may not recover. The doctors continued to treat Beer with IV fluid and antibiotics and after four days they were encouraged to see that she was able to move her arms and legs again.

After six days, Beer was conscious again and able to drink water and then milk, but she still had a fever. Once the type of bacteria that was causing Beer’s meningitis was confirmed, the doctors were able to change her antibiotics to specifically target her illness. Beer was treated with a course of antibiotics for three weeks and remained in the hospital for observation. In total, 14 month old Beer spent over a month in the hospital.

To her family’s relief, Beer was eventually able to return home to her grandparents house. She recovered with partial hearing loss in her left ear, and attends follow-up visits at the hospital every three months.

The hospitalization was not only emotionally trying for Beer and her family, but it was also very expensive. Though the hospital incurs the costs of hospitalization and medications, Beer had to stay in a special ward which cost the family 2800 baht, and they also had to cover the cost of commuting the 31 km from their home to the provincial hospital in their family pick-up truck along with food. This had a tremendous impact on a family that was already struggling to make ends meet. They are extremely relieved, however, that Beer made a recovery from the illness that has killed so many other children.

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Stories and photographs of the case studies are courtesy of the families and children with permission to PneumoADIP for use in educational and non-commerical purposes only. Reproduction or translation of the case studies, requires explicit, prior authorization in writing. Applications and enquiries should be addressed to pneuadip@jhsph.edu.