'We thought the back pain was only flu'

When 15-year-old Grey College learner Declan O’Connor experienced terrible back pain, he had no idea he was suffering from a serious kidney infection.

His mother Lesley, who was four hours away, rushed to his side at Mediclinic Bloemfontein. They share their story. ‘It’s any boarding school mom’s worst nightmare… getting a call to say that your son’s been taken to hospital,’ says Lesley O’Connor.

The call that came in late August 2016 was even more of a shock considering Declan’s active lifestyle. Excelling both on the sports field and academically, he juggles his passions for cricket, hockey and golf, as well as his love of subjects like physics, engineering, graphic design and history. ‘He’s a typical teenage boy, always busy and full of nonsense but very ambitious, well-grounded and close to his family,’ says Lesley. Having just visited Declan for Grey College’s music festival weekend, Lesley dropped him back at his hostel at noon on Sunday and set off back to Johannesburg. Declan complained of back pain but neither of them thought it was cause for alarm.

He’d experienced back pain about six months before, but had written it off as flu. ‘We thought that I was getting a bad case of flu again, as most of the boys in hostel had it at the time,’ says Declan. ‘My mom said to take some cold and flu meds and sleep, and if I wasn’t better in the morning the matron could take me to the doctor.’

Kidney infection emergency

Yet Declan’s pain continued to worsen. ‘By 2pm my back was so sore, that I couldn’t get up to go to roll call,’ recalls Declan. ‘Mr Steyn, the teacher on duty came to look for me and decided that I should go to the emergency centre at Mediclinic Bloemfontein as there were no doctors open on a Sunday afternoon.

They took some blood and urine samples and I had to wait for the results, which were concerning so I was admitted to see a physician the next morning. ‘I was put on a drip and was very nervous being in hospital on my own, but I was in constant contact with my mom and the nursing staff was very helpful and friendly. I felt a bit better knowing that my mom was coming to be with me the next day because I wasn’t sure what was going to happen.’ Lesley endured a sleepless night before she could drive back to Bloemfontein to join Declan.

‘It was a very anxious time as they couldn’t tell us what was wrong but when they phoned us to say that Declan was being admitted, we knew it was serious. I felt guilty dropping him off at hostel earlier that day and not taking his symptoms seriously – we really thought that it was back pain from flu as Declan hadn’t complained of any other discomfort. ‘Since I’m a freelancer and can work remotely, my husband and I decided that I’d go back to Bloemfontein early the next morning. I was at Declan’s bedside at 9.30 the next morning.’ 

The medical perspective

Mediclinic Bloemfontein nephrologist Dr Riaan Flooks – a physician trained in the diagnosis and management of kidney disease – was the primary doctor on Declan’s case. ‘Declan came to casualty with abdominal and back pain, nausea, vomiting and fever,’ he explains. ‘I saw him there where they suspected he had a urinary tract infection, which I confirmed but he didn’t have a simple case.

He had pyelonephritis, an infection of the tissue of the kidney itself. He was therefore started on intravenous antibiotics. A sonar was done to exclude the possibility of any renal or pararenal [within or adjacent to the kidneys] abscess formation which can be a complication of pyelonephritis. The test was negative.’ ‘I also asked urologist Dr Heinrich Reinhard Voigt to do a scope to exclude the possibility of an obstruction that could lead to a kidney stone,’ says Dr Flooks. ‘The scope showed that my one kidney had started to hemorrhage which they think could have been caused from the kidney infection,’ says Declan. ‘The doctors also wanted to do a gastroscopy as there were signs of reflux, so I had that on the Wednesday morning but it was clear.’ ‘Declan had an uneventful stay in hospital; he completed his antibiotic course and he was on his way – everything went well and he had well-maintained renal function throughout,’ says Dr Flooks.

‘Dr Flooks highlighted the importance of ensuring that kids drink plenty of water and not only sports drinks, especially when they spend a lot of time on the sports field. Declan’s obviously more susceptible to kidney infections than other kids his age, so it’s even more important for him. In future when Declan complains of a sore back, we’ll know that it could be his kidneys and react accordingly,’ says Lesley.