Spider?

Dallin started breaking out in bug bites on Tuesday night/ Wednesday. The funny thing was that he started out with a few bites on Tuesday night, and then they just continued to spread Wednesday- even though he hadn’t been outside. They didn’t itch or cause any discomfort. I called our pediatrician on Thursday, but he was out of town. The nurse said to just watch for a fever. Friday night he got a fever that we treated with tylenol/ motrin.Saturday morning, no change really, but when I checked a couple of hours later he had a gray puss filled nasty thing about the size of a quarter on his leg. Ben took him to the E.R. right away. He thought it might be a hobo spider bite, but the doctor  said they aren’t active this time of year. We did some research online later and found out that this is actually their mating season, so they’re more aggressive than usual, but I digress.  She (Dr. K.)  gave him antibiotics (daptomycin) through an I.V. and sent him home with an I.V. (not on a pump- is that called a hep-loc???) and told him to return the next day where she would most likely just take the I.V. out. Official diagnosis is cellulitis, which is basically a skin infection. In this instance it was caused by a staph infection. Saturday night it was difficult to control the fever- at one point he was up to 103 even with tylenol/ motrin and a bath. We were finally able to cool him down, thus avoiding another E.R. visit on Saturday.

Sunday at the E.R. same doctor saw him, gave him more antibiotics via the I.V., and gave him a prescription for an oral antibiotic (clindamycin) to be taken as well. She was going to be at an Urgent Care center on Monday and instructed us to see her there the next day.

Monday his fever FINALLY broke, and our pediatrician came back.  I called his nurse to see who I should go to, and she made us an appointment with our regular doctor. He was very concerned, but suggested continuity of care is best in this situation, since cellulitis can be lethal (good to know!) and implied that he would have admitted Dallin to the hospital instead of sending him home.  So, the pediatrician sent me back to the original E.R. doctor who is now at an Urgent Care about 15-20 minutes away. She looked at, said it was much less red, but took another culture of the puss (the previous two cultures had come back inconclusive). She wanted him to have more I.V. daptomycin, which she didn’t have at the Urgent care, so she sent us back to the E.R.  (Annoying side note- My pediatrician’s office is in the same building as the E.R.) I took a detour home so that Nurse Penny could go home, and I could give Dallin dinner/ 6:00 starch. We’d been gone since 1:30pm.

The new E.R. doctor (Dr. H.) took a look and said it is a possibility that it’s a brown recluse bite. He suggested that if it was, there would be a “gaping hole” under the gray flap of skin, and when he did another culture and actually lifted the skin,  there was definitely a hole. And it was “quite a bit bigger” than he’d anticipated. Poor Dallin screamed louder for that culture and cleaned the wound, than he did when he broke his leg last year. Sad, very very sad. So, Dr. H. gave him more daptomycin (Dallin still had his I.V. in), and sent us home again with instructions to come back early the next afternoon to re-check and possibly go up to the wound clinic. We got Dallin home just in time for 10pm cornstarch.

I hadn’t given him the oral antibiotics yet because I wanted to know what Dr. Joyce thought beforehand, and I’m wary of them. While in the E.R. on Monday night, Dr. H. told me not to fill that prescription just yet. He may or may not need it depending on the results of the next culture.

Tuesday afternoon we returned to the E.R. yet again, and were admitted quickly, but we were given a different doctor. The new one (Dr. D.) was not my favorite. He took a very brief look at Dallin’s leg and remarked that the cellulitis and the wound were definitely getting better. He mildly chastised me for not filling the second antibiotic and suggested I attend to that directly. When I started asking questions- ie “What caused it? What did the last culture say? How do you want me to dress the wound?” He said he’d get back to me and left the room to order more daptomyocin. I never saw him again. I was not happy. Granted, the marker outline of the cellulitis had definitely shrunk, and the “gaping hole” seemed to look smaller to me, but I wasn’t certain, they hadn’t measured it the night before, and they certainly hadn’t taken a picture, so how would he know?!?! I finally got the poor nurse to bring in Dr. H. from the night before. I think she had to go out on a limb for me, but I’m grateful she did. Dr. H. confirmed that it was looking better, but since Dr. D. was now attending to Dallin he couldn’t really answer any of my questions. So, my son was infused with more daptomyocin. Thirty minutes later the I.V. pump beeped, the nurse removed the I.V., and was ready to push us out the door with verbal instructions to see the pediatrician by next week or so. Naturally, I called for an appointment the next day.

The only thing that really seemed to make Dallin feel better was his Argo. Dr. Weinstein gave him a cute little stuffed dog at our last visit, and Dallin clings to that thing like none other- especially at hospitals. It’s been his favorite toy since May, but now it’s even more special.