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Rare fungus attacks Tampa teen's organs

TAMPA — The doctors couldn't provide the Slack family with any more words of solace or hope. Their daughter Carli was going to die, most likely within 24 hours.

It wasn't the way the Slacks thought it would end, even after learning three months earlier that 16-year-old Carli Slack had leukemia. Her doctors still seemed optimistic then, Kevin Slack said, and cited Carli's chances of survival as high as 98 percent.

But now, Carli, a Plant High sophomore, struggled to breathe on a ventilator, and her parents wondered whether to have doctors sedate her so she could go peacefully. It wasn't the leukemia that was killing her. It was a fungus that invaded her body and quickly began eating through her organs, putting her chances of survival, doctors told them, at zero percent.

Kevin Slack logged onto the Web site that Carli's 14-year-old brother, Christian, created for her in September as her condition was deteriorating, mystifying her doctors. Kevin pleaded for people to pray, just as he asked them to pray before when Carli worsened.

"Carli needs one more miracle," he wrote on Oct. 15.

Several people, strangers and friends, left comments promising their prayers.

This week, Carli is off the ventilator. She ate an orange Popsicle, protested her dad's kisses, and even got to go outside and feel the chilly air on Tuesday.

The Slacks have one message for the thousands of people who have visited Carli's site: Please, please keep praying.

• • •

The first sign something was wrong came during a Ferris wheel ride while Carli was visiting an uncle in Honduras this summer. Carli somehow banged her knee into her sternum, which caused a lingering pain in her chest that wouldn't go away.

She became lethargic and unsociable, which was unusual for Carli, the wild child among her three siblings. She often walked through the front door at home singing at the top of her lungs and annoying her older sister, Cassandra, and Christian, who also attend Plant.

So when Carli became weak and withdrawn in Honduras, her parents told her to come home. They took her to a public health clinic because they didn't have health insurance at the time, but the doctors there didn't seem concerned, said Edith Slack, an insurance agent who stopped working after Carli fell ill.

A few days later, Carli could barely get out of bed, so Edith, 40, took her pale daughter to the emergency room at St. Joseph's Hospital. Doctors seemed to immediately know something was wrong, and tests confirmed their fears: Carli had acute lymphoblastic leukemia, one of the most common forms of leukemia in children.

If treated quickly, though, the chances of remission are high, so Carli began chemotherapy soon after her diagnosis on July 22. Carli was devastated, but not because she thought she'd die. She was terrified of losing her long, black hair, which she loved to style every day.

"Baby, beauty is on the inside," Edith Slack tried to tell her daughter.

"No, it's not!" Carli snapped back.

The Slacks remember that period of bad news almost fondly now. Those were happy times compared to what lay ahead.

• • •

The first two weeks of Carli's chemotherapy treatments went smoothly, and there were signs she was entering full remission. She had some infections and fever, typical of chemotherapy patients, and her family kept praying it was almost over.

In August, Carli had a seizure, and doctors began looking at her infections more closely. They found leaks in her digestive system through an MRI scan, and eventually had to remove 2 feet of her intestines, her parents said.

Then doctors found nine more holes and performed a second surgery. Then something ate through a main artery in her leg, causing severe internal bleeding that nearly killed her.

"I think doctors suspected it was this fungus," said Kevin Slack, 41, a social worker. "But that was the first real indicator."

Doctors removed and inspected Carli's gallbladder and confirmed it was Mucor, one of a few species of mold that can affect humans — mainly leukemia patients and diabetics — though it's very uncommon.

Dr. John Sinnott, director of infectious diseases and international medicine at University of South Florida and Tampa General Hospital, said he hears of one case every two or three years in leukemia patients.

"It's a grim disease," he said, but did not want to give odds of survival or comment on a specific patient's story. "If the family reads this, I don't want them to lose hope."

Carli's doctors declined to speak to the St. Petersburg Times, but they have told her family the fungus is still attacking Carli's organs.

The Slacks, though, have stopped putting their faith "in the wisdom of man," said Edith Slack.

All that can save Carli now, the Slacks believe, is a lot of prayer. They wait for answers in every surgery Carli survives, every day she opens her eyes, every Popsicle she eats.

Emily Nipps can be reached at nipps@sptimes.com or (813) 226-3431.

>>Fast facts

Q&A

What is Mucor?

Mucor is one of few forms of fungi, or mold, that affects humans. It's commonly found in soil and plants, including fruits and vegetables.

How does it become fatal?

Once it enters the body of someone with a weak immune system, it thrives by invading blood vessels, and when it damages or cuts off blood vessels in an organ, that organ no longer receives blood and becomes damaged.

Am I exposed to it?

Constantly. It can be found in bread, grass, on a kitchen countertop and other items we come into contact with every day. But it's doesn't affect people with healthy immune systems, and according to USF and Tampa General's Dr. John Sinnott, it's only found to infect leukemia patients and diabetics. He did see one case in the late 1980s in a patient who had too much iron in his blood. Even among those with leukemia and diabetes, it is very uncommon. Sinnott personally sees or hears of only one case of Mucor every two to three years.

On the Web

To read updates on Carli's family, visit carlislack.page.tl

Rare fungus attacks Tampa teen's organs 10/29/08 [Last modified: Monday, November 3, 2008 6:50pm]
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