Sunday, May 06, 2007

Spider Bites

"How was your vacation, Katie?"

Before we left for vacation, we were lifting the very heavy Cricket out of the car when I remarked to Partner about a bite on the back of his head. "Hm," I said to her innocently enough, "it looks like something bit Cricket. Let's keep an eye on that."

On Thursday the bite was looking a little bit like a rash, so I called the good doctor so we could get it looked at before we left for vacation. Everyone was stymied. Was it viral? It looked a little like HSV, but it also could be bacterial? Or maybe it was just some contact dermatitis? Oh well, the doctor and nurse decided, we'll sample it, but for now, they told us, treat it with the Bactroban. Which we neglected to do until Saturday afternoon when the rash had expanded considerably.

Sunday then it looked better-- why hadn't we started treating with the Bactroban earlier, we asked ourselves. The rash might be gone by now! We patted ourselves on the back for finally starting the treatment the doctor recommended. I consulted Dr. Google and decided Cricket had impetigo. Or poison ivy. But had no idea where he got either, since it's generally not our practice to let children with weepy sores hold him or let him roll around in shiny leaves of three. Oh well, we thought, crisis averted. Bactroban is working!

And then I woke up Monday morning and the back of his head was huge. I mean, it bulged out almost like an abscess and was oozing. We called my mother to come and look at it. We were all a little freaked. I tell you, it looked really bad and angry red. We called our pediatrician in Michigan. And she thought we should take him in somewhere we they regularly treat children ASAP. Although, she wasn't sure what was going on either since the bacteria culture came back negative and so did the rapid virus test.

Luckily there's a fine little practice five minutes from the house and we saw a doctor who agreed it looked really bad. And he had a diagnosis for us: MRSA. That's methicillin-resistent Staphylococcus aureus. And as soon as he said MRSA, that's when I freaked out. The rash was worrying, but MRSA? See, I had this slight obsession with MRSA when I took Microbiology. I watched documentaries on it. I read books about it. Why was I so intrigued? Because this bacteria is a bad motherfucker. People lose limbs to MRSA. Lives even. And now it was on the back of my kid's head? I was a wreck, crying when we left, crying in the car, just holding Cricket and being very scared. I called our pediatrician's office in Michigan.

It was a good thing I did. When we talked to one of the doctors in the practice he reminded me that CA-MRSA (community acquired) is very different from HA-MRSA (hospital acquired). He said that CA-MRSA is pretty common these days. He said he would have prescribed the same drugs, the same dose as the island doctor. He told me if I was concerned about Cricket's GI system (and I was) I could give him a pro-biotic yogurt. I felt so much better and by Tuesday, it seemed like the antibiotic was working.

We were happy again and as I fed him Wednesday morning, Partner slathered the Bactroban onto Cricket's head. We were heading out for the day, so she really globbed a bunch on there. Cricket himself seemed normal, as he had through all of us, but maybe a little warm. We took our thermometer and a little vasoline and headed off. In the late afternoon after touring the very cool South Carolina aquarium, I went to change his diaper and take a temp. 99.8. Not soaring, but warm. And then I flipped him over to inspect his little head. And holy shit, the rash had expanded again, tons of little dots all over the back of his head. Bright angry red again. And then lo and behold, dots on his arms. Legs. Hands. Cheeks. Another call the Michigan pediatrician, who said, take him in ASAP. And so Wednesday night found us at the MUSC Children's hospital.

Are you getting the idea that vacation wasn't very vacation like for us?

The doctor at the children's hospital felt the rash looked like classic MRSA too, but she thought that the topical ointment was irritating his head so we should stop. Who knows what the other dots were? Don't worry. Go home. Come back if the temp goes over 101. Or he gets an outbreak on his trunk.

After this trip, I was convinced that the head rash and the arms and legs were two separate rashes dastardly coinciding with each other. The arm and leg rash seemed to be confined to where I had put sunscreen on him. Nothing on the trunk or upper arms, and I never put sunscreen there. Ha. I had figured it out. (Don't tell me the six month rule for sunscreen: Our pediatrician noted it's better to put sunscreen on him than not, and the oral antibiotic he was taking made him extra-susceptible to burning.)

Once again, we were convinced he was getting better. But don't let your guard down, because by now clearly we now the trajectory of this story: One day good, one day bad. So Thursday = good day. Friday, well, the one cluster of dots on his leg was looking like shit. We were concerned. And then Saturday, yesterday, the day we were leaving, we woke up and took off Cricket's pajamas and he was bright red. Everywhere. His back was aflame. He stomach, his arms, his head, around his eyes. Everything either bright red or pin-pricked red. Once again, we called the doctor's office where the nurse manning the phone told us to take him to be seen before we got on a plane. We ignored her advice and instead got on an earlier flight. By this point I think we were both convinced that any hospital he went to was going to check him in. As much as we love South Carolina, we wanted to come home.

The child looked bad. It was scary. My mom cried a little when looking at him. I was worried because Staph aureus sometimes produces a toxin that causes something called Scalded Skin Syndrome. Or he was allergic to the antibiotic. We decided to skip the morning dose.

We took him straight the hospital here. By this point he had a fever. They got us in to see a doctor very fast. Where once again we were told it looked like MRSA alright. And the redness? Definitely an allergy to the drugs. Stop the drugs. Now know that kid is allergic to sulfa drugs. Start new drugs. Hope new drugs work because only two drugs can treat the MRSA and he's allergic to one! He had blood cultures taken, a CBC, and an IV dose of the new antibiotic. We were there for hours.

I'm exhausted. He looks better today, seems to be happy to be home. He's napping again and maybe getting back on his schedule will help him get better faster. We're praying the new antibiotic works and that his allergy resolves quickly. Hopefully it isn't MRSA because if it really is, this all might happen again and again and again until we go through a decontamination procedure. I don't know what that entails, but I can tell you, I think I won't like it. I think there'll be some assumption that we're all colonized. Even though I'm terrified of the MRSA, I want to go back to the micro lab and do a culture from my nose and Cricket's nose. All I need is a mannitol salt agar or blood agar....

I'm also hoping that our pattern of good-day-bad-day is over and that they all start to be good days. Because today is good. I'll have to die of exhaustion if tomorrow is a bad day.

I'm so ready to start Organic Biochem on Tuesday. It's going to feel like a walk in the park compared with this past week.

And that's how our "vacation" was.



Blogger Erin said...

Oh Katie, how horrible for all of you--particularly Cricket! I hope he's really on the mend and that you're all OK, and that this never, ever happens to him again. Poor baby! MRSA is so scary!

1:21 PM  
Blogger Rhoda said...

I am so sorry to hear about your child's MRSA battle! If you go to www.MRSA there is a lot of good information on treating CA MRSA. I will be praying for you and your family and hope you are all taking precautions since this is very contagious. Best wishes, Rhoda

2:32 PM  
Blogger Kim said...

What is it with MUSC? The last time I was in that vicinity, I spent 8 hours in their ER with a friend who was having an allergic reaction to nuts.

I am so sorry that you are dealing with MRSA. What a scary, scary infection. I wish you were close by--I'd steal some MSA or blood agar from my micro lab for you. But since I can't do that, I'll just keep the Cricket in my prayers.

10:40 PM  
Blogger Clementine said...

Oh no--I'm so sorry that Cricket's so sick! What a scary time for you and Partner. I'm hoping and praying that Cricket will be feeling better soon.

1:42 PM  
Blogger frog said...

Good Christ!

If y'all need a hand with anything, just yell. We're EXCELLENT errand runners!

1:43 PM  

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