The Boy is eight months old when the problems begin: His right half of his face is warped. The parents take him to a local hospital in the Chinese province of Sichuan.
Doctors recognize that there is a partial paralysis of the facial nerve, the do you want to address with acupuncture. For a week the Baby will be treated, but his condition was not improving. About three weeks later, the Boy gets a fever.
Immune cells in the nervous water
Now, the physicians carry out more detailed Tests, among others, examine the blood and nerve water, the so-called cerebrospinal fluid, in the small patients.
In his blood a lot of white blood cells, swim abnormally, the so-called C-reactive Protein is increased. Both may be indicative of a bacteria-induced inflammation, however, other causes. In addition, the hemoglobin value is too low. This is the red blood dye, which enables the transport of oxygen in the blood.
In the cerebrospinal fluid, Doctors can also find large quantities of white blood cells. In Healthy, the cerebrospinal fluid is almost free of these cells. Also, this may point to a bacterial infection. Tests on various viruses not to beat, including Epstein-Barr, rubella, and Herpes. A magnetic resonance imaging (MRI) of the brain shows no abnormalities.
Although no bacteria grow in scale cultures in the laboratory, however, the doctors suspect that the Baby has a bacteria caused inflammation of the brain. This is life-threatening, prompt Action is therefore necessary: give the child several antibiotics to eliminate the bacteria.
Antibiotics do not beat properly
The following two weeks, the Baby receives different active ingredients. In the meantime it developed a severe rash, the inhibitory only using a inflammation By means of subsides. Despite the Antibiotics, the Boy has an increased body temperature. A re-analysis of the cerebrospinal fluid shows that the number of cells dropped in it, but still much too high.
So the child will be moved eventually in a clinic at the University of Sichuan, where Liquan Wang and colleagues of the little patients to accept, the later report in the journal “Medicine” on the case. You examine the Baby thoroughly. Again, you are looking for traces of various viruses that could be responsible for the disease – but you will not be able to find. Tests for bacteria are negative.
When listening to the lungs with a rattle you. On the left side of the neck the Doctors to feel for enlarged lymph nodes. The number of white blood cells in the blood and cerebrospinal fluid is still too high. And: In the MRT, some of the pathological changes in the brain now.
The Doctors give the child to more antibiotics. But, you start to doubt the diagnosis, according to a bacteria-triggered inflammation of the brain.
Finally, analyze the white blood cells of the patient more accurately and, in addition, a bone marrow sample. This shows that only certain types of white blood cells are present in large numbers and that these cells are largely Mature.
The Baby suffers from a very rare Form of blood cancer, called acute monocytic leukemia. The body produces uncontrolled, these immature cells. Because the bone marrow is heavily involved in this, decreases in parallel with the production of red blood cells, as well as the for the clotting of blood necessary for blood platelets.
The cells have obvious targets in the Central nervous system damage, what can explain the changes in the brain, and the facial paralysis of the child.
In the case of acute leukemia, a rapid Intervention is especially important. Detected in a timely manner, it is possible to fight the blood cancer, with chemotherapy or with a bone marrow transplant successfully. The parents, however, decide against these treatments. You leave with the Baby to the clinic.
The Doctors did not describe in their case report, the motivations of the family. It is possible that the chance of recovery was due to the delayed diagnosis is already so low, that they wanted to experience the few remaining time with your child rather beyond the hospital.
In the aftermath of the physicians looking in the literature for similar cases and found a few reports in which children with leukemia, suffered from a facial paralysis.
A paralysis in the vast majority of cases has another cause and is not caused by cancer. Nevertheless, Physicians should think of a possible leukemia if you have ruled out the more likely reasons, write to the Chinese doctors.