Poisoned girl gets Christmas gift of life
If ever the Bouwers needed a Christmas miracle, it was when their 12-year-old daughter ate poisonous wild mushrooms and went into liver failure that threatened her life.
Red Cross Children's Hospital had not been offered a suitable donor liver for three months, but the day Candice Bouwer arrived from Benoni, a liver became available.
Candice's parents, Sharon and Willa, who will remain at their daughter's bedside for the three months she remains in Cape Town to recover from the transplant, are overwhelmed at the stroke of luck that saved their child's life.
Candice's grandfather, Steve Pretorius, who picked the mushrooms, could not be saved.
He died in hospital of kidney and liver failure the day Candice was transferred to Red Cross.
Sharon Bouwer, mourning the loss of her father while celebrating her daughter's recovery, wants their story to serve as a warning, to prevent similar heartbreak for other families.
Although they do not know where Pretorius picked the mushrooms - only he and Candice ate them - specialists suspect it was the death cap, or Amanita phalloides mushroom, that was to blame.
Even experienced pickers, according to a warning on an American website, can mistake the death cap mushroom for one of its non-toxic cousins.
Mignon McCulloch, a consultant paediatrician taking care of Candice, said her poisoning signs and symptoms had followed the usual course.
She ate the mushrooms on Friday, November 30, and started getting sick on the Sunday. First she had diarrhoea, then started vomiting.
By the Tuesday night she was unconscious in intensive care at a Benoni hospital, and only a liver transplant could save her life.
Her grandfather died on the Wednesday morning, while Red Cross Children's Hospital staff were preparing to receive Candice, not sure they could do anything for her, considering the shortage of donor livers.
But fate proved to be on her side.
Professor Alistair Millar, who led the surgical team that did the transplant, said they had heard about the donor liver almost exactly at the same time as Candice arrived on a mercy flight from Gauteng.
"She went straight into surgery that night. We started operating at 11.10pm and finished up at 7am the next day.
"There have been a few problems, but she is doing extremely well," he said.
Liver specialist Wendy Spearman warned that only a tenth of a gram of mushrooms per kilogram of the patient's weight was needed to cause severe poisoning.
If the antidote was not given within 48 hours, the toxins would have reached the liver and/or kidneys, and the gut.
"Candice was extremely lucky. If the donor liver hadn't arrived at just the right time, we would have lost her," said Spearman.
When Candice's liver was removed, it was found to be damaged to the extent that hardly a single living cell remained.
Candice's case is only the second referral Red Cross Children's Hospital has had for assessment for liver transplant following mushroom poisoning.
The other was a small boy eight years ago, who died.
Spearman said there was no popular culture of mushroom picking in South Africa, and people should be extremely cautious.
Candice said it was everyone's prayers that saved her life. "I was so surprised when I woke up and they told me I was in Cape Town," she said.
Then, as if to wipe out any question of her return to good health, she made her mother promise to take her to the beach, and up Table Mountain.
- Call the Organ Donor Foundation on the toll-free number 0800 22 66 11.