Katie Richards woke up Monday morning with a scratchy throat, but by evening the 14-year-old girl who just graduated from eighth grade at Hedrick Middle School was struggling for her life.

Katie Richards woke up Monday morning with a scratchy throat, but by evening the 14-year-old girl who just graduated from eighth grade at Hedrick Middle School was struggling for her life.

In an extremely rare complication, a viral infection had settled in her heart, causing it to fail.

Now Katie is in intensive care at Doernbecher Children's Hospital in Portland with machines pumping and filtering her blood and breathing for her. She is listed in critical condition.

"She's entirely kept alive by machines," said her father, Curtis Richards, who is at her bedside along with her two younger sisters — Amber, who is just weeks away from turning 13, and Ashley, 11.

"Doctors say she's plateaued now. She can't get any sicker," he said Thursday afternoon as the family kept an hour-by-hour watch on Katie's life.

Sunday she was a healthy active teenager who took her sisters to the park. Her Monday malaise "wasn't even like full cold symptoms," her dad recounted. By midmorning, she complained of achy joints, so she took a Tylenol and a nap.

Ashley, who wants a career in medicine, tended her big sister and around 2:30 p.m. came to tell Richards that Katie wasn't OK. She was lethargic and just not herself, he said, so they headed to the emergency room at Rogue Valley Medical Center.

There, Dr. Matthew Hough zeroed in immediately on symptoms of heart failure, ordering a slew of lab tests and an echocardiogram, then calling Oregon Health & Science University.

"He said it didn't look good and she had to be seen in Portland," Richards said.

An air ambulance arrived in Medford at 10 p.m., but Katie's condition couldn't be stabilized to fly until 1 a.m. Tuesday and her heart stopped en route to Portland, but the crew resuscitated her, her father said.

Richards and his two younger daughters hit the highway and got to Portland at 6:30 a.m. Tuesday. Doctors there explained that Katie had myocarditis, a heart infection. It was caused by an influenza virus.

Dr. Michael Silberbach, a professor of pediatric cardiology at OHSU and Doernbecher, explained that there are two types of myocarditis — so-called acute myocarditis, which can linger for weeks or even months before a person even shows symptoms, and fulminate myocarditis, in which a virus strikes suddenly, making a healthy-seeming person deathly ill within a day or two.

"It's so extremely rare," Silberbach said of the sudden virus-caused infection that struck Katie. "I had never seen a case of it."

It's unknown why some people develop the deadly infection from common viruses, but it seems to have to do with some unique quirk in their immune system, he said. If such patients survive the initial heart failure, they often recover completely, while patients with the slower moving acute myocarditis can suffer lasting heart damage.

Doctors must provide aggressive care to keep blood circulating as the heart fails and hope the patient can beat the infection, Silberbach said.

Katie underwent a 3.5-hour open heart surgery Tuesday to evaluate the damage and slow her heart rate, which had rocketed to 171 beats a minute, exhausting the heart and failing to pump blood, Richards said. She remains on a cardiac bypass system that pumps blood through her body. A ventilator breathes for her, but increases the risk of her lungs filling with fluid. She is on continuous dialysis, as her kidneys have shut down.

On Thursday, the family met with a full team of doctors, nurses and social workers to discuss how long to keep the intensive treatment up.

"I know she can pull out," Richards said. "I believe she can fight.

"We've gone through tough times."

Richards was injured in a fall in 1996, when the family lived in Michigan, and now suffers a neurological condition that leaves him unable to work and dependent on a disability payment of $1,100. He and his wife divorced, then he and the girls went to live with his father and aunt in Las Vegas about two years ago. Both his father and aunt died within months, and Richards couldn't afford to keep the house. He and the girls set off for a safer, more affordable community and landed in Medford last year.

"We've been such a team. It's like a machine. If one of the cogs is lost, it just won't work the same," he said, his voice choking with emotion as he contemplates the possible loss.

Rick Valentine, a Jackson County sheriff's detective whose daughters are friends with the Richards girls, stepped in to help the team. He established a Katie Richards Medical Fund at Rogue Federal Credit Union. Donations can be made at any branch.

Reach reporter Anita Burke at 776-4485, or e-mail aburke@mailtribune.com.