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When an Infection Becomes Life-Threatening

Caroline Deneen woke up one morning unable to see out of her right eye. At Mass. Eye and Ear, Drs. Daniel Lefebvre and Christopher Hartnick recognized Caroline’s condition as ocular cellulitis – and they knew they had to act fast.

Today, Caroline Deneen is a 12-year-old student athlete who plays soccer, basketball and lacrosse and enjoys indoor rock climbing.

But four years ago, she was in the intensive care unit fighting a sinus infection that, through sheer bad luck, had spread to her eye, causing orbital cellulitis, and then to her brain.

On April 1, 2013, just a few days before her ninth birthday, Caroline woke up with a very swollen eye. Her family brought her to the pediatrician, who immediately referred her to a local hospital as the swelling worsened. Recognizing that Caroline’s case was somewhat uncommon, the local physicians arranged for her to be transferred to Massachusetts Eye and Ear.

The family soon learned that Caroline’s infection had begun to attack her organs. She was treated by eye plastic surgeon Daniel Lefebvre, M.D., and pediatric ear, nose and throat doctor Christopher J. Hartnick, M.D., who worked together to drain the fluid causing the swelling.

After that initial operation, Caroline stayed in the hospital. “For the first three or four days after the surgery, she did great,” said Julie Deneen, Caroline’s mother. “But she wasn’t improving, and they couldn’t find an antibiotic that would treat the liquid they removed from her eye. While they were looking, the infection spread to her brain cavity.”

A setback

Caroline spent her 9th birthday in the intensive care unit, where the nurse brightened the room, decorating it for the occasion. That day, Caroline learned that she needed emergency brain surgery to drain the fluid from her brain.

Dr. Lefebvre wanted to avoid performing a full craniotomy, a surgery that requires an incision directly into the skull. Instead, the medical team decided to make an incision above Caroline’s eyebrow and get to the brain through that incision. Dr. Lefebvre led the surgery—which required hundreds of stitches, internal and external—and it was a success.

“The level of care and concern Dr. Lefebvre showed throughout this process was astounding,” said Mike Deneen, Caroline’s father. “He is not only a fabulous physician, but he is also a gentleman, and he really took us under his wing.”

“A lot of these events took place in the wee hours of the morning,” Julie added. “And Dr. Lefebvre was there with us through the entire process.”

Coming home — for good.

After the surgery, “She was back,” Julie said. “She was sweet Caroline again.”

After the surgery, doctors found an antibiotic that would treat Caroline’s infection. She returned home with a PICC line—a tube inserted into a vein to deliver medicine for an extended period of time—which she had for about two months. Although recovery took some time, Caroline retained full vision and was able to return to playing sports.

Her illness and recovery have taught Caroline that it is important to “Keep believing in yourself,” she said. “It will get better.”

For more on Caroline’s story, check out the video above.

Download a transcript of the video.

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