From a Small Cut to a Leg Infection

February 10, 2022

From a Small Cut to a Leg Infection

Vichea is a four-year-old boy who lives in Bavel District, Battambang Province, around 150km west of AHC. His father, Oudom, is a carpenter and his mother, Sreylay, is a housewife who takes care of Vichea and his two-year-old brother, Vibol. Oudom supports his family with an average income of five dollars a day from his woodwork.

In late December 2021, Vichea was playing outside with his friends as he usually does. Unfortunately, this time, he fell off his bicycle. Oudom and Sreylay did not think much of the fall, as Vichea only got a minor cut on his right leg.

Over the next ten days, Oudom wrapped his son’s cut with traditional herbs found around his village. He believed that the herbs would help the wound heal itself. For communities in the rural countryside of Cambodia, modern resources and education are scarce, and many still believe in spiritual and traditional Khmer healing methods that can be harmful.

Vichea’s condition got worse; he could no longer walk, play, or eat. Vichea could not control his irritable cries.  Oudom noticed that Vichea’s temperature kept rising. The traditional herbs had infected Vichea’s small cut.

Oudom and Sreylay did not know what to do, nor did they have any savings to bring their son to a hospital. Desperate, Oudom called his brother who lives in Siem Reap for advice, who recommended they go to AHC for the best treatment, no matter the ability to pay. The family took a two-hour bus ride to AHC right away.

Upon arrival, an AHC nurse noticed Vichea as his irritable cries were so severe. The nurse saw that Vichea had an unusual wound that needed immediate attention.  He was quickly transferred to AHC’s Surgical Unit for examination.

AHC’s surgery team conducted a head-to-toe examination and suspected osteomyelitis (infection in long bones in the leg), due to the severe swelling, redness and abnormality in Vichea’s lower right leg. Therefore, the team ordered tests for blood cultures, as well as an ultrasound and X-ray for the right leg. The team knew they had to take Vichea to the operating room immediately.

As the team detected pus in the bone, they performed an incision and drainage with bone window, which took one hour. Surgeons used a surgical irrigation system to supply serum and antibiotics, Ceftriaxone and Cloxacillin, into the bone. After removing all pus out of the bone, the incision was quite long.

“I was so worried and terrified. I thought the doctors would have to cut off his leg. I never experienced any of my family members in this situation before.”

Oudom, Vichea’s father

48 hours after AHC’s surgical team performed the incision and drainage with bone window, results of the blood and pus culture tests showed staphylococcus aureus, a bacterium that commonly causes osteomyelitis. Vichea continued to receive the broad-spectrum antibiotic Cloxacillin through intravenous to fight the bacterium. It took one week for Vichea to feel better again. He started to smile again, eat and play as he had before his accident. His fever subsided and his temperature went back to normal.

“All the doctors and nurses at AHC have been so kind. If I had brought Vichea to any other hospital, they would have blamed me for taking too long to bring my son there. Here, I do not have to feel ashamed or embarrassed. I know that everyone just cares for the recovery of my son.”

Oudom, Vichea’s father

As per AHC’s guidelines for osteomyelitis, patients need to stay in AHC for two weeks to complete intravenous antibiotic treatment. For Vichea, AHC’s surgeons added one more week of admission due to concerning blood culture growth.

Oudom has not been able to work for the past three weeks, as the family has been in Siem Reap to take care of Vichea. AHC’s Social Work Unit is supporting the family with daily food and hygiene packs to alleviate their financial strains. “I wish there were more hospitals and healthcare facilities like AHC in the country. I would have not able to pay for such costly operation and my son would not be better like he is now,” shared Oudom. Vichea has now completed his intravenous antibiotic treatment and will go home tomorrow. AHC’s surgical team is confident that Vichea will soon go back to playing with his friends again, and grow to be healthy and strong.

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