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Fletcher Has Blood Infection: Gallbladder Could Be the Cause, Doctors Say

Posted on: Saturday, 18 February 2006, 03:03 CST

By Jim Warren, The Lexington Herald-Leader, Ky.

Feb. 18--Gov. Ernie Fletcher has developed a potentially serious bacterial infection in his bloodstream, and his doctors said they were trying to determine the cause last night. They suspect the infection is related to his recent gallbladder problems.

Such blood infections can be life-threatening, but doctors stressed that Fletcher was stable and resting relatively comfortably at St. Joseph East hospital last night.

He was receiving a broad-spectrum antibiotic to fight the infection and seemed to be improving, they said. More specific antibiotics will be given once doctors pinpoint the cause of the infection and what type of bacteria are involved.

Dr. Mark Dougherty, an infectious diseases expert called in to help with the governor's case, said Fletcher will need to remain in the hospital at least several more days.

First lady Glenna Fletcher said Fletcher told his parents of his condition over the phone last night.

"In a way it's good news," she said. "It could have been a lot worse, so we're very thankful that it is treatable."

Began feeling ill last week

Fletcher's ordeal began when he developed abdominal pains last Saturday. He was hospitalized Sunday afternoon after the pains worsened. Doctors quickly determined that he had a gallstone in his bile duct, and pancreatitis, an inflammation of the pancreas. The gallstone was removed on Monday, followed by the gallbladder on Tuesday.

The governor's recovery had been moving somewhat slower than expected since then, but concerns didn't grow until he began feeling worse about 6 p.m. Thursday, according to Dougherty and Dr. Joseph Fine, who removed the governor's gallbladder.

Dougherty said Fletcher's temperature rose to 102.7 degrees Thursday night and was as high as 101.7 yesterday, though it later went down. Doctors briefly considered placing him in intensive care but decided that wasn't necessary, Dougherty said.

"He seems to be a lot more comfortable now; he's resting a lot easier; he's not in any significant pain. He doesn't have a fever right now," Dougherty said last night.

A blood culture was taken Thursday night, and results early yesterday confirmed the bacterial infection, Fine said. He said Fletcher received a CAT scan yesterday, but it didn't reveal the cause of the infection.

"At this point, we don't see anything that would be an obvious contributor, and we think it's probably related to his gallbladder," Fine said.

Infection not unusual

Doctors noted that Fletcher's gallbladder problem was "very serious" at the time the organ was removed. Fine said Fletcher had a condition called necrotizing colicystitis, which essentially meant his gallbladder was "trying to die." In such a situation, it wouldn't be unusual for bacteria from the gallbladder to get into the bloodstream, he said.

Dougherty said blood infections are a generally recognized complication from gallstones in the bile duct. He added that Fletcher's gallbladder was in "bad enough shape" that it could have caused a bloodstream infection by itself.

In retrospect, it was fortunate that Fletcher chose to have his gallbladder removed this week, rather than waiting, Dougherty said.

"That unquestionably was the right decision. I think that if he had waited ... he almost certainly would have gotten a lot more ill than he is right now."

Dr. Ardis Hoven, an infectious diseases expert and former president of the Kentucky Medical Association, said last night that patients with such infections usually respond well to treatment. Hoven is not involved in Fletcher's case.

"Most of these patients recover without significant complications," she said. "I will be very optimistic that this will be the situation in the governor's case."

Doctors seeking cause

Fletcher has been exhibiting relatively low oxygen levels since the gallbladder procedure. Doctors had thought that was a result of Fletcher's inability to take deep breaths, an after-effect of the operation. Doctors had been giving him supplemental oxygen to help.

But Dougherty said they now suspect the low oxygen was a result of the bloodstream infection. He said the governor would be checked for any signs of pneumonia this morning. Fletcher is continuing to receive supplemental oxygen.

Dougherty said a key will be determining what type of bacteria are involved. He said it's now "very critical" to get Fletcher on the right antibiotic "to get the infection turned around." He predicted that the governor would be in the hospital until at least Tuesday or Wednesday.

"It really depends on how he does, and it's too early for me to say at this point," he said. "I expect that he'll turn around fairly quickly over the next two to three days."

He said Fletcher probably would have to remain on antibiotics for a while after he leaves the hospital.

Staff writer Jennifer Hewlett contributed to this report.

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Copyright (c) 2006, The Lexington Herald-Leader, Ky.

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Source: Lexington Herald-Leader (Lexington, Ky.)

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