Pediatric Resident Update
The pediatric resident came by with a comprehensive update covering several important topics.
Good News — Lab Results: Chase’s CRP — an inflammatory marker that measures infection and inflammation in the body — has dropped dramatically from over 100 to 37. This is a significant and very encouraging development. It tells the team that the surgeries achieved good source control, meaning the infection has been effectively addressed and the body is now responding positively. This is one of the most concrete pieces of good news since Chase was admitted.
The Infection Organism: The team has still not been able to identify the specific organism driving the infection. Unfortunately the cultures collected during surgery had already been heavily exposed to antibiotics, making it difficult to isolate the exact bacteria. While immune cells were detected in the samples confirming active infection, the specific organism remains unknown. However because Chase is responding so well the team sees no reason to change the current antibiotic regimen.
Braces Decision — On Hold: After consulting with both the ENT and ophthalmology teams, the decision was made to hold off on removing Chase’s braces today. The reasoning is encouraging — neither team is currently planning any MRI imaging in the next few days based on Chase’s positive trajectory. Two days of consistent improvement following surgery has reassured all teams that urgent reimaging is not needed right now. The braces question will be revisited in the morning. Importantly the team confirmed that during the week the dental team can respond more quickly if needed — making the weekend timing less critical.
Discharge Timeline: This is the question everyone has been waiting for. The resident was thoughtful and honest — while it is still day to day, the team would be surprised if Chase goes home before Wednesday. Plan for at least 3 to 4 more days. The primary determining factor will be what the infectious disease team decides tomorrow regarding the antibiotic course — oral versus PICC line — and how Chase continues to progress.
Antibiotics Going Forward: The PICC line versus oral antibiotic decision remains the central open question. The infectious disease team is not expected to have a definitive answer tonight but should have clearer direction tomorrow. This will be the key factor shaping the discharge plan.
The Eye Drain: The drain remains in place and is still actively draining — which means it is doing exactly what it should be doing. The guiding principle is simple — if it is still draining, it stays in. Once drainage tapers off the oculoplastics team will make the call to remove it. That team continues to round both day and evening and will check in again later tonight.
Tonight’s Plan: Chase will go NPO again at midnight as the team continues its nightly protocol of evaluating him fresh each morning before making decisions for the day.
How’s Chase? 