A Frightful Week for A Little Girl

It was the middle of the night when 4-year-old Brooke Dawn suddenly awoke in her Northern Virginia hospital room shrieking, "Ow, ow, ow!" But it was what she said next that her mother, Patricia Dawn, says she will never forget.

"Mommy, it hurts so bad I can't stop screaming," said the normally self-contained little girl.

"That's when I realized how bad things were," Dawn recalled.

By then Dawn and her daughter had spent several days at a Northern Virginia hospital, as doctors tried to figure out what was causing Brooke's high fever, sore throat, red lips, stiff neck and headaches so severe they sometimes left her writhing in pain. Baffled by the constellation of seemingly unconnected symptoms, specialists had ruled out meningitis and juvenile rheumatoid arthritis. Brooke had been given intravenous antibiotics for a possible throat infection and had developed a severe measles-like rash that blanketed her torso and limbs. Doctors worried she might be in the throes of a dangerous drug allergy.

In the end, what was wrong with Brooke turned out to be none of those things. A week after she became ill, an infectious-disease specialist made the correct diagnosis. Treatment was begun swiftly, in an effort to avert potentially lethal complications that might not surface for years.

"She was diagnosed in time," Dawn said. "Others are not so fortunate. I often wonder what would have happened had we not fought her discharge from the ER."

On Oct. 27, 2008, Brooke and her parents had just returned from two weeks in Florida. The trip, which included a visit to Disney World, had been a treat to help Brooke cope with her mother's protracted hospitalization and recovery from a ruptured neck disk. "She was very traumatized because I was bedridden for months" unable to care for her, Dawn said. The Florida trip had been a big success.

The night the family returned, Brooke woke up crying at 11 p.m., clutching her head and complaining of a bad headache. She had no fever, and her mother gave her Tylenol for the pain, which seemed to work.

Brooke seemed fine the next morning, and her parents chalked the headache up to sinus problems, a frequent occurrence. But after preschool she seemed lethargic and soon spiked a high fever. The headaches returned and at times were so severe Brooke was writhing in pain. Her parents kept giving her over-the-counter pain relievers, which didn't help much.

The next morning she developed a new and more worrisome symptom: The right side of her neck hurt and seemed rigid. Alarmed because she had had meningitis at 14, Patricia Dawn immediately took her daughter to a pediatrician, who performed a strep test and took some blood. The doctor decided meningitis was unlikely and believed Brooke, whose white blood cell count was elevated, might have contracted a virus.

That night, after she seemed unable to move her neck, Brooke's parents took her to an area emergency room. A CT scan showed a swollen lymph node in her neck and an infection behind her throat. Doctors gave her intravenous antibiotics and told her parents she might have nicked the back of her throat with a sharp straw. At 2 a.m. they told the Dawns to take Brooke home.

"I pitched a fit," said Dawn, a former hospital chief financial officer who has many relatives who are physicians. Brooke, she insisted, was too sick to be discharged. The little girl was admitted.