Skin infections – our latest challenge 5

Last year Zac had a horrible spot on his elbow that turned into a rash with an erupting abscess at the epicentre. The first GP who saw it said it was nothing. A few days later when it was oozing, another GP decided it did need anti-biotics and the pus needed to be squeezed out. She did it while I held him and it is a memory that still haunts me. The doctor went pale as she did it and both of us went temporarily deaf from the ear piercing screams of my brave little hero.

Ever since then we have always been very vigilant at keeping an eye on any ‘weird’ skin stuff. He did have one other very nasty rash that was diagnosed as eczema but until last week, his skin has been pretty good. But then a week or two ago Zac had a few ‘bad nights’. Lots of fidgeting and getting up in the night, itchy, very sweaty and his tummy seemed very bloated. These were all problems that were part of every day life until we started him on antihistamine twice a day. Because he has been so well I foolishly started to think perhaps he was growing out of his condition and so I became less vigilant with the medicine. I don’t like pumping him full of drugs every day so perhaps was subconsciously challenging him. BIG mistake.

Over a period of days he became more and more irritable and hypersensitive, particularly when getting dressed. He kept grumbling that his ear was hurting as I took his tops over his head but I couldn’t see anything. Then one day I noticed a tiny spot on his inner thigh. Looked a bit pink but nothing to worry about. Or so I thought.

A couple of days later he came home from pre-school complaining that his leg was really hurting. By now the spot had trebled in size and developed a head. The area around it was hard and red and raised, just like the time before. I had some fusidic acid (anti-biotic cream) left over from last time and so put some on it. I also gave him some anti-histamine and nurofen to help with the pain and to prevent Zac’s body over-reacting to whatever was in there.

I decided to take him to the doctor the next morning. As I washed his face, I gently brushed his cheek with the cloth and he screamed – and screamed and screamed. His lips went blue and he cried for ages. It brought tears to my eyes. I felt so bad that I had hurt him. I looked inside his ear and could see the ‘shell’ was so swollen that it was starting to close up and the ‘hole’ was disappearing.

We managed to get an emergency appointment with the nurse practitioner. She was very kind and said both were infected and needed a strong anti-biotic. My heart sank when I read the prescription – flucloxacillin. It sounded like the one he had been prescribed it last time and it was so utterly foul that he screamed and it was months before he trusted me with a medicine spoon again. In the end we had another one prescribed and he would only take it from Tom!

I hoped it might not be the same. Rushed him home and poured out the first dose. It smelled pretty sharp but I hoped I was wrong. As the medicine hit his tongue and mouth he wailed, he jaw fell open, out came the medicine and he screamed and screamed. He said it was hurting his mouth, he said it stings and just kept saying ‘ow, ow’. I tried to make him swallow some, he cried and cried. A few minutes later he was sick. I tried it. No wonder he was sick. It was the foulest, most bitter medicine I have ever tasted. I couldn’t swallow it either. Just the taste of it on my tongue made me heave, so no wonder the poor little boy was sick. It must have been like swallowing salt water with the juice of 1000 lemons squeezed in!

So I rang the surgery and asked if there was something else he could have. I know he needs a strong medicine, but surely a weaker one that he can keep down is better than one that will just make him sick and distressed. Happily they relented and told me to come back and collect a different one. This one is erythromycin. Both are used in the treatment of skin infections – I looked it up. So was happy that this one would work – eventually. He took it happily and went to bed. He had a terrible night with the pain.

The next day his ear and leg were worse but he was determined to go into ‘school’ as it was his first day in big school. I told the teachers that he needed medicine and so for his very first day in their charge I had to sign a form and deposit medicine with them! Apparently he was very brave and took his medicine like a good boy. I warned them that he might yelp a bit if someone knocked him while playing and they assured me they would watch out for him. He came out happy enough and had not had any problems – but he could hardly walk and was exhausted. As the day had gone on the swelling on his leg had increased dramatically. We dosed him up with all the pain relief allowed and prayed that the infection would not get any worse or lead to something more nasty.

We gave him a long soak in the bath too, to try and soften the now green scab. It seemed to work and it gave him some relief. He fell asleep soon after and once he was in a deep sleep Tom decided to see if he could knock the scab off and get some of the pus out. I don’t know how he didn’t wake up but somehow Tom managed it. He squeezed loads out apparently – I couldn’t watch. He cleaned it and covered it and left him to sleep. An hour or so later he woke up crying and saying he was hot. He wanted to sleep with me. It was a hot night, so we got the fan on him – I was nervous in case the infection had spread and he had a fever. I watched him all night!

He was restless and woke up several times. At about five in the morning he went into a very deep sleep and when he woke up several hours later I noticed that his ear was full of blood and pus and my pillow cases were dirty. The one in his ear had burst and the contents were everywhere. I had been warned by the nurse that it might happen and she told me not to clean it. She said they are self cleaning and just let the gunk dry up and fall out. So we did. A week later it is just about all gone but still very sore I think as Zac is very wary of me coming at him to wash his face.

So for the last week his leg and ear have been in recovery. It has been very slow and the wound on his leg is still quite livid. The hole has closed up but there is a big red ring around it and there is still some hard swelling. His ear ‘shell’ is back to normal size, just a bit grubby looking and a bit pink. But he does have one other ‘ninja-ree’ as he calls his injuries. He has also been very tired. I guess that was due to missing so much sleep because of the pain or possibly his body fighting the infections. Both I suppose.

Mid way through the chaos of the leg and ear we noticed he was also complaining about his finger. He does chew his fingers nails and sometimes the skin around them gets sore. Perhaps he had got some of the ear ‘grime’ into the open would at the edge of his finger nail or perhaps it is unrelated. All I know is that by last Sunday evening he was holding his swollen finger aloft and it looked like that thing from ET when he holds it up to the sky and it glows! He had one of these infections a couple of days after he was born, so I knew what we were dealing with – paronychia. Also requires anti-biotics. I looked it up and although they do respond to anti-biotics it can be slow and it is sometimes better to ‘cut and drain’ it. I felt sick at the thought. It seemed to be getting worse by the minute and I couldn’t face the thought of taking him to the surgery and seeing a nurse take a lancet or needle or whatever to his little hand. I also wasn’t sure how I would ever be able to hold him down. It took three of us when he had his last round of blood tests and it took four when he had his skin prick tests. Both of those cemented his phobia of needles and doctors!

He had another terrible night. Thanks to the finger pain. I was just alarmed that even though he had been on antibiotics for 4 days his finger had got worse and worse. The next morning, we knew we had to get it ‘seen’. I begged Tom to come with me. I am not squeamish at all and have always taken the children to all their jabs etc on my own. They have both always been so brave that it never bothered them or me. But now Zac is four and a half and associates going to the doctors with nothing but pain, it has become very difficult. Physically as well as emotionally. He is a big strong boy and if he is fighting to get out of my arms, I cannot hold him still for long and that is why I need the extra pair of hands. Also he seems to be far more comforted by having his Daddy there than me, so I knew he would be less afraid if Tom came.

So we saw the nurse again and she looked pretty horrified at his finger. She said she would prescribe another weeks worth of anti-biotics and thought it probably would only get better once it was ‘cut and drained’. She said she could do it but would rather not have to hurt him. She suggested we do it ourselves, perhaps while he was having a long soak in the bath or even when he was asleep. She gave us a sterile needle and wished us all the best! Bizarrely, I was happy at this outcome. I really didn’t want to have to see him go through what would have been agony. As he had slept through Tom opening his leg wound, I hoped the finger ‘surgery’ would be equally painless for him. In the evening gave him another long soak and put him to bed full of pain relief and anti-biotics. An hour or two later ‘Doctor Tom’ went up with his sterile needle. I waited downstairs. He came down about ten minutes later and it was done. He did what the nurse advised and just aimed at the biggest greenest balloon of pus and gently pushed the needle against it. Loads came out apparently. Tom gave it a little clean and re-dressed it. Amazingly, Zac didn’t wake up all night, but the next morning he did notice he had a different plaster on.

That was Monday night. He has had quite a good week. Still very nervous of catching his various wounds so playing very cautiously compared to normal. He has taken all of his medicine like a good boy and had some very good and long sleeps. Today he just has a plaster on his finger. I haven’t seen it for days. He won’t let me look at it. He doesn’t like to look at it himself and will only let Tom or the pre-school ladies change his plaster. But at least he will take his medicine from me now which is a great relief. So it looks like he has come out of all this quite well in the end.

I was so worried that with all those infections happening all at once, that his little body would attack itself as it often does and he would end up with a fever of 40 and we would be back in hospital – as we have several times in the past. I guess we got the anti-biotics just in time or perhaps the anti-histamines helped – perhaps they stopped his body attacking itself even more. Perhaps if I had given him them more regularly in the first place this might not have happened. Zac still suffers with a lot of unexplained itching from time to time. I wonder if he had scratched too hard and got dirt in these tiny wounds? I guess I will never know but I am determined to find out if this is in any way connected to his other problems.

It might sound crazy. How can skin infections be related to food intolerance? But skin and tummy troubles can be caused by histamine intolerance. This is one of the theories that Dr Adam Fox put forward when we met last year. The more I think about it the more it now makes sense. Zac’s allergy tests were all negative despite the fact his body cannot cope with many of these triggers. His triggers are foods that carry large amounts of histamine. He also reacts to inhaled triggers such as pollen, dust etc. His skin is dermatographic which Dr Fox demonstrated by lightly dragging a pen along his skin. It instantly marked – apparently this showed that histamine was rushing to the surface of the skin ready to attack the invader. It was this demonstration that stuck in my head this week and that is why I started looking back at Zac’s case and what we know. I am convinced this is what he has http://www.allergyuk.org/common-food-intolerances/histamine-intolerance

I think Dr Fox was also pretty sure that is what he has. That is why he prescribed daily anti-histamine and nalcrom. http://www.netdoctor.co.uk/allergy-and-asthma/medicines/nalcrom.html

What Dr Fox also advised was that after all the test results come back we discuss them and work with a dietician to develop a plan. I suspect he knew that the results would all be negative and confirm his diagnosis. We saw Fox privately and he referred us back to our local NHS hospital (to save us money) but he said it was a very good allergy clinic staffed by Doctors he rated very highly. But that is where it has all fallen apart. We first saw them in November. They issued the tests. We met after Christmas, the Doctor told us they were negative and that she would see him again at the end of this year! As Zac was relatively well and I ‘believe’ in the NHS, I thought I could wait, but this week I caved. Yesterday I emailed Dr Fox and he said I should make an appointment with him. As he is the only person who seems to believe that you can still be ‘allergic’ and worthy of treatment even if your tests are negative, I feel I have no choice. So I look forward to meeting him again. I will definitely be giving Zac his twice daily hit of anti-histamine and I will keep a very close eye on his skin! I have also had a wager with Tom as to what his diagnosis will be. I have a ’50’ riding on ‘histamine intolerance’. Will let you know.

Here are some pictures. I have none of his finger as he won’t let me look at it!

Zac's spot - at the start

Zac’s spot – at the start

Getting worse

Getting worse

Ready to burst.

Ready to burst.

Getting better

Getting better

after the ear spot went

after the ear spot went

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5 comments

    • Thanks Stuart. It was hard going at times – but others have it worse – but you can see why I get so much from yoga now. A real therapy for me. As for Zac each new episode teaches us something new and that is why I think it is good to share, as it seems we are not the only ones with histamine issues and we are certainly not the only ones struggling to get a diagnosis and treatment.
      See you next week. Nic

  1. It sounds really very problematic, I am totally sympathized with it. I have read most of your articles and found all of them interesting and knowledgeable. This one is also great as your previous ones with great information.

    • In the end it turned out to be a colonisation of MRSA. My husband had it too. The entire family had to be treated. We had to use a top to toe special wash and nasal spray several times a day for a week. Had to change every towel after every use – and boil wash. Same for all bedsheets and clothes – clean every day and wash everything at 100 for a week. We were ‘clear’ after and have remained clear. But he does still have eczema flare ups from time to time and does have sensitive skin – but no more boils.

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