Diagnosis and beyond

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- NIRMAL JOVIAL

Around 6pm on September 11, a 40-year-old named Anto was admitted to Aster MIMS Hospital in Kozhikode. He was transferred from another hospital in Vadakara, after he showed severe pneumonia symptoms and breathing difficulty. Soon after his arrival in Aster, Anto died of cardiac arrest.

A day earlier, two other patients—a nine-year-old boy named Rizwan and his 25-year-old uncle Raheem—had been admitted to the hospital with similar symptoms. Dr Anoop Kumar, director of Aster North Kerala Cluster (Critical Care), was already looking into the cases. “Since we came to know that Rizwan’s father, Jalal, had died showing similar symptoms just two weeks earlier at a local hospital, we were on high alert,” said Dr Kumar. “We came to know that Jalal had a multi-organ failure, and he died without a proper pathological diagnosis.”

Raheem, Jalal’s brother-in-law, said pneumonia was diagnosed as the cause of death. “He was in ICU first and later on ventilator,” Raheem recalled. “Back then, we (Raheem and Rizwan) had no symptoms. But within 10 days, I got fever and Rizwan developed breathing difficulty along with fever. And, by September 10, we both were admitted to Aster.”

The Aster team found out that Jalal had developed diplopia (double vision) and slurring of speech— unusual in pneumonia cases, hinting at a potential brain problem. Rizwan also showed pneumonia-like symptoms and generalised convulsions, and was on non-invasive ventilatory support.