In Nigua, Dominican Republic, relatives of Yewri Guillen share photos and memories of the 18-year-old Nationals prospect who died last Friday of bacterial meningitis. (Victor Calvo/Associated Press)

More than a week before his death, Yewri Guillen called his mother from inside the Washington Nationals’ baseball academy in Boca Chica, Dominican Republic. They had seen each other three days earlier, at his home in Nigua, when his head first began throbbing. “Mami,” Guillen told Sandra Perdomo, “my head hurts more.”

As a Nationals athletic trainer tended to Guillen, his headache and fever worsened. It looked like he had the flu. On April 8, he asked to return home to Nigua, a coastal municipality about 90 minutes west of the academy. At 5 a.m. on April 15, a budding prospect discovered by the Nationals in fall 2009, whose baseball skill became his working-class family’s hope for a better life, was dead. Yewri Guillen grew up in a small, wooden house and played shortstop almost every day, in a park his mother could see through the window. He was 18.

“He was a bright kid,” Perdomo said in Spanish in a telephone interview from the Dominican Republic. “And he had a bright future. Here, the coaches and all that saw him play said that he was going to go far. He was a great player.”

Nationals officials had no way to know Guillen’s headache and fever foretold a fatal case of bacterial meningitis, a rare, menacing disease that is difficult to detect until it brings a victim near death. Major League Baseball investigators believe the Nationals did all that could have been expected of them to treat Guillen and to prevent the disease from spreading to any of the roughly 35 other players in their academy.

“It’s heartbreaking that an 18-year-old player not only can’t play baseball, but he’s dead,” General Manager Mike Rizzo said. “It’s really difficult for the organization. It’s a blow to the whole organization. We’re certainly looking at things we could have done differently or done better. We’re certainly investigating that.

Yewri Guillen (Victor Calvo/Associated Press)

“I think we handled it as well as could be handled. I think we handled everything above board and first-class. These are our assets. We have to make sure these players are well taken care of. We feel that everything we did was above board and to the finest.”

Guillen’s death will spark changes in how the Nationals, and perhaps all of baseball, vaccinate players signed in the Dominican. Bacterial meningitis can be prevented by vaccination, which in a developing country such as the Dominican Republic can be lacking. Roughly 1,000 cases of bacterial meningitis occur in the United States every year, a figure kept low by widespread vaccination. The Nationals, Rizzo said, will implement a program in which every minor league player, both American and Dominican, is inoculated. MLB also will consider such a program.

Guillen’s death also raised concern among Dominican officials over the hygiene of the 30 major league baseball academies on the island. On Monday, Bautista Rojas Gomez, the country’s minister of public health, announced that the agency would investigate the death and work to establish medical guidelines for all academies. And in response, he said, Guillen’s family and the other players at the Nationals’ academy were preventively treated.

An insidious disease

When Guillen went home to see a doctor, the Nationals still did not know what they were dealing with. Guillen had been infected with bacteria that lives in the nose and throat of roughly 5 percent or 10 percent of the population. About 99 percent of the time, people who carry the bacteria do not become infected.

The bacteria “don’t live in the environment, on surfaces or doorknobs,” said Tom Clark, an infectious diseases expert from the Centers for Disease Control and Prevention. “They live in the nose and throat of healthy people. But it’s not really the setting itself that puts you at risk.”

Bacterial meningitis is an insidious disease, Clark said, because of the diabolical combination it presents. The symptoms at first resemble a case of the flu or a nasty cold. But it degenerates swiftly, sometimes leading to death within 24 hours.

For Guillen, a trip to the doctor posed complications. MLB still had not officially approved his contract, which meant his health insurance policy, standard in every player’s contract, had not yet kicked in.

The Nationals paid for all of Guillen’s medical expenses. But when Guillen was taken to a health clinic in Santo Domingo, he wasn’t treated because his family could not produce a deposit of 50,000 pesos — roughly $1,300, Perdomo said. He was taken to another clinic in the same city, where he was treated.

Guillen spent a week in the hospital. He died last Friday. The Nationals were shocked — here was a happy, healthy 18-year-old, a shortstop who someday might play in the major leagues, who could deliver his family from poverty. It looked as if he had come down with a headache or caught the flu. A week later, he was dead.

“The reason there’s so much attention to meningitis when we see it, it’s that teenagers or adolescents are at a little bit increased risk,” Clark said. “It looks for all the world like a random occurrence. It tends to strike young, healthy people. There’s not a real predictable occurrence or easy to tell if he was at risk.”

Nationals help out

Since Guillen’s contract had not been formally approved, the family has yet to receive the $30,000 signing bonus Guillen agreed to with the Nationals. But the Nationals will pay the signing bonus in full, a source indicated. The contract also includes a life insurance policy standard in every minor league baseball contract.

“The kid was the only hope for that family to get out of poverty,” one Dominican source said.

All along, the plan was for Guillen to help his working-class family. His father, a long-time motorcycle taxi driver, has been working at his new job at a factory for the past year. Guillen’s mother runs her own small snack business, selling cookies and drinks from their home.

“We knew that when you reached the big leagues we would live differently,” said Perdomo, Guillen’s mother.

Friday evening, upon learning of Guillen’s death, Nationals starting pitcher Livan Hernandez, who is from Cuba, requested a team meeting. He asked teammates for cash donations for Guillen’s family. Within half an hour, Hernandez held a cardboard box with more than $6,000 inside.

Nationals Director of Latin American Operations Johnny DiPuglia flew to the Dominican immediately to visit Guillen’s parents and attend the funeral Saturday. Rizzo received permission from team owner Mark Lerner to pay for Guillen’s funeral and burial expenses.

On Monday, DiPuglia will fly to the Dominican for the opening of the Nationals’ Dominican Summer League camp, which will happen as scheduled. Three days later, with the entire DSL team and the Nationals’ Dominican staff, DiPuglia will drive to Nigua and present Guillen’s parents with the money. He’ll invite them to throw out of the first pitch of the DSL team’s first game. On that day, and for the whole season, the players will wear patches with Guillen’s initials on their uniforms. A memorial at the Nationals academy is planned.

“This is something that’s going to stick with us, that’s going to last with us for a while,” Rizzo said. “It hits home, and it hits hard. These things are tragic, and it happens so fast.”

‘Had a chance’ at majors

The Nationals first discovered Guillen in October 2009, when DiPuglia met Guillen. “He was a very angry kid when I first met him,” DiPuglia said. “Just a little angry about life. He had to fight for every meal that he’s gotten. When you’re living in that type of stress every day where you don’t know what the next day is bringing, it’s tough on a young man.”

The Nationals attempted to sign Guillen in 2010, but a misunderstanding about his middle name caused MLB to balk before approving the deal. After they filled out more paperwork and the league conducted another investigation, the league allowed Guillen to agree to terms on a contract with the Nationals in February.

DiPuglia slipped him $20 bills for food and gave him shirts and shoes out of his own closet. He gave him gloves and other equipment. Guillen became more comfortable around teammates and made friends. He walked around with a smile on his face.

During intrasquad games, Guillen would forget the signs and steal bases without permission. Sandy Martinez, the manager, would remove him from the game as punishment, even if he was safe. After a few weeks, Guillen continued stealing bases without approval. But when he did, he would call timeout and take himself out of the game. As he walked off the field, Martinez howled with laughter.

“He had a chance to play in the big leagues,” DiPuglia said. “I know Yewri Guillen is a person I will never forget.”