hi! this is shalini from Nepal. my mom aged 46 was in PD for 2 yrs n she had got perionities 2-3 times in between so we thought to get her transplanted so we went to chennia, india for tranplantion
there also she got peritonitics so we took her to khaliaapa hospital.in first day they did culture of the fulid n started treatment 4 bacterial infection.after 2 days nothing came in her report and her condition was becoming more critical.she had started vomiting regularly anything she had she vomited so they did the culture again then after 4 days they got that they she is suffering from fungal infection n started her medicines 4 fungal treatment(fungizone) they said that they’ll have to remove the catherar otherwise it won’t improve. so after 3 days they removed it. the next day they made an temporary fistula in her neck for her hand fistula didn’t succeed n did her first homodialysis.next day she was even more serious, her BP was to low and her pulse was also decreasing so doctors shifted her to ICU and gave her oxygen in ICU they could control her BP n Pulse after 3 days n shifted her to ward by then they had attched a gastorial tube n prohibited us to fed her or give her even water.that day after 2 hours she started Shivering with cold even though it was hot and for half an hour she was shivering doctors said its a sideeffect. For 3 days same thing happened.they again did her HD in 4th day(they used to do her HD in every 3 days).then they said that they doubt that the shivering is due to fistula infection so they need to send it to do culture and removed her fistula. doctors said that her fungal infection is 98%finished and in few more days she will be released but again her BP went down and pulse also very low and she was shifted to ICU this time very serious.in ICU she was doing well in first 2 days but in 3rd day mom was not fine she was very weak and when i saw her sleeping her eye lids were half open that day doctors said this is due to overdose of antibiotics and she extremely needs HD so they again made a temp fistula and did her HD but to maintain her BP and pulse doc did her HD in 1and 1/2 hrs which should be done in 3 hrs.after dialysis they said they need blood urgently so dad got the blood, they didin’t tell us what happened in the morning they said that internal bleeding has started in her abdomen because of infection,they said they have kept her in ventilator and if bleeding stops she can survive but it didn’t stop that day and doctor said there is no chances of her survival doc said that even her heart isn’t working and there is no chances and she is surviving only because of ventilator and suggested to let them remove her ventilator for she won’t survive so we allowed them to remove her ventilator and she died later in her death summary we got to know that she had fistula infection also.i don’t know what is the reason of her death, infection or that HD.
I am sorry to hear about your loss. It sounds like your mother’s death was sudden and shocking to everyone. So far as to what caused her death, I am a social worker, not a doctor. Your mother’s doctor should be able to explain to you what he/she believes caused your mother’s death. From your message, it sounds like she had infection in multiple locations – fungal peritonitis in her peritoneal cavity and an infection in her vascular access. I suspect that the infection entered her bloodstream overwhelming her body and causing sepsis. Sepsis can life-threatening and 60% of those who have other medical problems and sepsis die. Here’s information on sepsis that you can read to see if it looks like what your mother had.
Hi shalini,
i am a indian.
i can understand ur doubt and concerns.
i too lost my father this april because of a silly reson hypothyroidism not detected by doctors.
now i seroiusly doubt the calibre of indian nephrologist.they take very seoius things very casually and blame the entire episode on dialysis saying dialysis patient dont live for long but u also know throuh these wonderfull websites that u can lead a normal and healthy life but it needs high quality nephrological intervention which is neither in nepal nor in india.
as far as ur mother problem is concerned fungal peritonits is not like regular bacterial peritonits and it generally leads to cathetar loss and mortality rate is also very high and as beth pointed out sepsis is the major contributing factor.
now one thing i want to know .ISPD guidelines clearly suggest once bag is cloudy u go for cell count,gram stain and culture test immediately.u get cell count and gram stain report the same day and if presence of yeast is there in gram stain it generally predicts fungal infecton and when u get culture report the third day it is confirmed.
so hospital missed the golden chance of confirming the fungal infection quicly and they have to do the culture again{this may be the fatal mistake} i know this very well because i have seen some patients not surviving becasue their cathetar was not removed quickly and agressive anti fungal treatment started for the sole reason culture report was sterile and getting the second opinion costed them their life.
i live in ranchi jharkhand and PD patients have to die if they have fungal infection because lab always show culture report sterile { most of the time they cant detect even gram positive steph aureus }.
ithink she died because her fungal perionitis was not detected quickly and this caused her death .
HD didnot performed because her BP was low and u cant blame it.
Hi shalini,
i am a indian resident of ranchi,jharkhand
i can understand ur doubt and concerns.
i too lost my father this april because of a silly reson hypothyroidism not detected by doctors.
now i seroiusly doubt the calibre of indian nephrologist.they take very seoius things very casually and blame the entire episode on dialysis saying dialysis patient dont live for long but u also know throuh these wonderfull websites that u can lead a normal and healthy life but it needs high quality nephrological intervention which is neither in nepal nor in india.
as far as ur mother problem is concerned fungal peritonits is not like regular bacterial peritonits and it generally leads to cathetar loss and mortality rate is also very high and as beth pointed out sepsis is the major contributing factor.
now one thing i want to know .ISPD guidelines clearly suggest once bag is cloudy u go for cell count,gram stain and culture test immediately.u get cell count and gram stain report the same day and if presence of yeast is there in gram stain it generally predicts fungal infecton and when u get culture report the third day it is confirmed.
so hospital missed the golden chance of confirming the fungal infection quicly and they have to do the culture again{this may be the fatal mistake} i know this very well because i have seen some patients not surviving becasue their cathetar was not removed quickly and agressive anti fungal treatment started for the sole reason culture report was sterile and getting the second opinion costed them their life.
i live in ranchi jharkhand and PD patients have to die if they have fungal infection because lab always show culture report sterile { most of the time they cant detect even gram positive steph aureus }.
ithink she died because her fungal perionitis was not detected quickly and this caused her death .
HD didnot performed because her BP was low and u cant blame it.
thanks for ur reply.earlire i had doubts that its doctors fault