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Patient Stories: Meredith Littlejohn

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A 19-year-old college hopeful and cancer survivor dies from an antibiotic-resistant infection.

Meredith Littlejohn’s parents, Steve and Stefanie, remember their daughter’s hope-filled optimism and amazing courage throughout her treatment for acute myeloid leukemia (AML).  She was first diagnosed in mid-November 2012 when she was a high school senior at the top of her class. Meredith, or “Mert,” had an exciting life ahead of her, and would soon be accepted early to EmoryUniversity. 

There were four rounds of chemotherapy over the next months, with brief home respites between rounds until April when she went into remission. Meredith and her family and friends were thrilled she was able to attend her senior prom and graduation. But, in June of 2013, she suffered a relapse. She resumed treatment and did well until August, when she contracted Candida, a fungal infection that is not uncommon in AMI patients. Her infection did not respond to traditional treatments and her infectious diseases doctors called colleagues across the country to find an effective treatment.  Fortunately, they found an effective combination of therapies and her infection cleared.

Meredith spent her 19th birthday in the intensive care unit (ICU), where she still managed to throw quite the party with her friends. She was thrilled when a few of the hospital residents she thought were cute dropped by to wish her happy birthday, and she also received a tweet from an actress on her favorite TV show “Gossip Girl.”

In September, Meredith left the ICU and returned to the children’s oncology floor, but then she was diagnosed with a Pseudomonas infection under her arm. Her doctors monitored the infection as she had more cancer treatment. 

Because the infection was resistant to newer antibiotics, doctors prepared to use colistin in case it spread to her blood stream. Colistin is considered an antibiotic of last resort due to its extremely toxic effect on kidneys, which are already compromised in someone undergoing chemotherapy. 

In early October, Meredith had a bone marrow transplant, which was successful. Her blood was 100% replaced by the donor’s blood, changing her blood type. However, infection still plagued her and she began receiving colistin. As mucus plugs accumulated in her lungs, intubation helped her breathe and her doctors performed several plug removal surgeries. Meanwhile, although the infection spread to her lungs, her body responded extremely well to the surgeries, and her family and friends looked forward to rehabilitation.

To begin rehab, she had a tracheotomy – an incision in her windpipe – so she could get rid of her breathing tube and function during physical therapy. During the tracheotomy procedure, her blood oxygen levels dropped significantly and she went into septic shock because the Pseudomonas had reached her bloodstream. Although the doctors resuscitated her and did so again when she went into shock the following day, on the next day, the infection prevailed despite the team’s best efforts. Meredith died a year after her AML diagnosis – not of cancer, but of an antibiotic-resistant infection. 

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