Meet Fletcher

Fletcher has just turned four. Sometimes he’s Ironman. Other times he’s Captain America or Batman.

He loves construction sites and emergency vehicles and he has a couple of cool scars that hint at a very different story underlying his current sunny childhood.

He’s the third of three children and was Ricky and Rianna’s largest baby. She was breastfeeding and the family was bonding with big sisters who adored their new brother.

“At six weeks he was fine one day and then the next day he wasn’t feeding,” said Rianna. “By the afternoon he was lifeless and the GP told us to get him to the hospital which meant The Royal Children’s Hospital [RCH].

“He was limp and not responsive by the time we got to the Emergency Department. The doctors thought he had meningitis and tried to do a lumbar puncture but couldn’t. He was in intensive care for a few days.”

There was no firm diagnosis and specialists from a range of RCH departments conferred to try to identify the cause. A specialist in childhood infections, Penelope Bryant recommended that, without another diagnosis, it was safest to treat it as a brain infection. Under the care of the Hospital-in-the-Home (HITH) program, Fletcher went home with his family and a secure drip in his vein. With a nurse attending each day to administer antibiotics, he became more alert and gave his parents the reward of the odd little smile.

Fletcher completed treatment and life went on. At eight months he underwent a routine procedure but the following day was anything but routine.

“The doctors thought he had developed sepsis [a bloodstream infection] from a local skin infection and started him on antibiotics,” continued Rianna. “Then his torso began to turn red and purple.”

Penelope put Fletcher on broad antibiotics and was concerned there was dead tissue under the discoloured skin, but this was not borne out by multiple scans. He went into kidney failure, however, and was readmitted to intensive care where he didn’t open his eyes for days. A line was put into his chest because his veins had collapsed from having so many intravenous lines. Rianna lost her breastmilk.

Because Fletcher wasn’t improving, surgeons agreed to exploratory surgery that found a thick layer of pus from his armpit to his groin. They washed it all out and Fletcher started to improve.

The pus led to a firm diagnosis of methicillin resistant Staphylococcus aureus (MRSA) infection, which occurs when the relatively common skin bacteria ‘staph’ becomes resistant to commonly used antibiotics.

“We often don’t know why kids get resistant bugs,” said Penelope. “Sometimes it’s because of previous hospital admissions or antibiotic use; sometimes because a family member has been in hospital or travelled overseas; and sometimes we can’t find an underlying reason because these bugs just exist in the community. We do know that, where possible, the best place for treating infections, resistant or otherwise, is at home.”

While Rianna admitted she was scared to leave the hospital – ‘our safe place’ – the family was also delighted to have their boy back amid the controlled chaos of everyday life. Again, Fletcher received his intravenous antibiotics via HITH care.
Numerous follow-up tests showed Fletcher’s immune system working well, so there has been no explanation why the MRSA caused Fletcher to have such a serious infection.

Those dark days are now more than three years past but they’ll never be quite over for Rianna.

“I’m the kind of parent who has to be across everything,” she said, “and I’m very overprotective now, although he’s a strong little kid who’s hit all his milestones.

“I thought at the time, ‘This isn’t my story. This isn’t my reality.’ But we know we’ve been very lucky and I’m very grateful to the RCH. I live my life being grateful.”