Impetigo? (panicking mom here)

[nvts]

I got it as a teenager on top of poison ivy! Yup, what a pretty picture I was!

It doesn't sound like it to me! It sounds more like a rug burn from the fall. Either way, keep it clean and see the doc.

Speaking of cellulitis from a bug bite, dh just finished up surgery on that about 3 weeks ago, and my daughter had the exact same thing on the back of her leg. We've got some "bitey bugs" this summer. It's not gonna be pretty!

Let us know what the doc said!

Beth

[TerryJ2]

I had impetigo in HS. On my face. How humiliating. I have to admit I liked the sunlamp though.
It spreads ... and you're only seeing one sore. It's hard to dx from your description, but my bet is that's not what you're seeing.
My PC had a MRSA infection last yr. After we discovered what it was, and we stripped her bed and washed everything, she just wore a huge bandage on her leg and wore long pants all the time. It's when you don't know you've got it that it's most contagious because you're touching everything. So once it's covered -- in your case, a Bandaid sounds fine -- it shouldn't spread. Whatever it is.
I'd make an appt. for Mon.
Good luck.

[Star*]

Daisy -

(said standing up and picking stuff off shirt, pants, shirt, pants, brushing, brushing, shaking, picking)

I do not (pick, brush, pick shake) have MRSA.

I know 'cause I looked at my skin real close. lol



SLSH - what is the outcome of the child's wound? WILL SHE KEEP HER LEG?

[Hound dog]

Star

I was also checking in to see what the decision was. Let us know. We board aunties are prone to worrying. lol

[wakeupcall]

My gfg is HIGHLY suseptible to impetigo. He gets it all the time. We keep a tube of presecription Bactroban to treat it with. If you catch it early, you're in great shape...otherwise it takes awhile to clear. I also had it as a teen...all over the side of my face!!! I was mortified! The doc said I probably got it off the water fountain at school.

[Marguerite]

Staph aureus is the bacterium that causes pimples. It's no big deal, we have it on our skins all the time.

MRSA was originally called Multi-Resistant Staph Aureus, but then they changed it to Methycillin-Resistant Staph Aureus.

A big cause of resistance in bacteria, is when we use antibiotics improperly. Use in agriculture, for example, when it's not used to treat infection but only used to promote growth - very wrong and we're now reaping the benefit.

Also, if you routinely use antiseptics, you are reducing your immune systems' exposure to pathogens and this can actually make you sicker in the long run, as your body forgets how to fight disease. Your immune system needs its regular micro-doses of bad stuff, in order to do its job properly. As my mother used to say, "We all got to eat our peck of dirt before we die".

PC got impetigo when she was a toddler. She had a huge blister on her chin but it didn't spread (maybe because we got to it early and kept her hands away from it).

You can cover it with a loose bandage - we stick a wide band-aid down onto PC's so there was plenty of chance for air to circulate and for it to dry.

Legally (school, etc) we're not permitted to send kids to school with uncovered impetigo. I remember being lined up at school while they checked for sores. Anyone with possible impetigo got sent home until the sores were covered.

Treatment - oral and/or topical antibiotics are generally recommended these days. In the days before antibiotics, the sores were covered and often treated with iodine or similar antiseptics. I suspect hydrogen peroxide was used but not everybody would have had it. Just about everyone would have had iodine, though.

Not that I'm recommending iodine now.

You CAN use hydrogen peroxide. Here is a link:
http://www.ncbi.nlm.nih.gov/pubmed/6265438

I also looked it up to see why people are saying to not use peroxide - from what I can determine it's because it's not considered effective. Hydrogen peroxide will break down to water and oxygen when it meets tissue fluid (due to enzymes in the serum) and the opinion seems to be that this means it's not effective.

I disagree - when you bubble oxygen into the tissues, especially tissues infected with staph aureus, you are making darned sure that this particular infection is not going to go anaerobic and burrow in. As I said before, we all have staph on our skins. The problems with staph infections are where it burrows into the tissues and changes its habits.

On the skin, staph is exposed to oxygen in the air. It uses the oxygen, the bacteria multiply using oxygen in the process - they are multiplying aerobically.

Some bacteria prefer to grow in the absence of oxygen. They do better. And some bacteria, like staph, can switch around and do both. For anaerobic infections, hydrogen peroxide is brilliant at killing it (as long as it can get to the infection). But too strong a peroxide, or too much - it can leave white spots on your skin which is a sign of damage (not major). 3% is plenty strong enough.

We also use ti-tree oil - it's a natural antiseptic plus the oil keeps the skin supple enough, and sticks around too. I dab peroxide on first then mop it with a clean cotton swab stick, then dab on ti-tree, then cover it until the next treatment.

I do this for all staph infections.

Something else to do for infections getting nasty (ie going anaerobic) - we use regular hot, salty water baths.
The theory behind this, as explained to me by a microbiologist friend, is - these bacteria divide every four to five hours. But exposure to heat that is as hot as you can stand it, while it's not hot enough to kill the bacteria,
does interrupt the cell division process. The bacteria have to begin the division process over again. This means that when they try to divide again, they are almost twice as old as they should be. The older the bacteria, the bigger. The bigger they are, the more difficult it is for them to survive.

But you keep doing the heat treatment, every three hours. This keeps on interrupting the cell division process until the bacteria begin to die of old age. At that point your body can mop up the rest.

A problem we've had in our family at various times, is staph infection in the tissues. It starts because an almost microscopic split has happened in the skin. Or maybe a puncture (such as a small thorn) or a torn cuticle allows the bacteria to enter. But because it's such a tiny opening, there isn't enough oxygen getting in so the bacteria begin to divide WITHOUT oxygen. THis changes the behaviour of the bacteria in other ways also, and can begin to look like flesh-eating behaviour. If associated with this, also dividing anaerobically, you get Streptococcus B, then it can be really nasty (and flesh-eating). I've had it, PC has had it - both on our fingers. Strep lives in your throat, it is what gives you a sore throat if it gets out of balance.

Working together anaerobically, strep and staph can do some nasty damage. The strep causes tissue inflammation and at the edge of the wound it separates the skin from the underlying tissue. It looks blistered but more - it looks white and soggy. Then the staph moves into the open space (it's not so clever at separating the skin from the tissues as strep) and makes a lot more pus. THis then allows the strep to push in deeper. And so on.

Again, we've successfully treated this without antibiotics (because I have no choice). We soaked the wound (usually on a limb - finger or tow mostly, in our family) in salty water as hot as we could stand it. We would have the hot kettle standing by to top up the water for a good, hot, half-hour soak. We then removed the dead skin to let the peroxide do its job and bubble oxygen through the (currently oxygen-hating) bacteria. We then applied topical ti-tree oil or topical antiseptic/antibiotic (if prescribed) and covered the wound until the next treatment session (to begin 3 hours after the previous session finished).

We repeated this with three hour intervals for as many repetitions as we could, on at least three consecutive days. It's a hassle, taking antibiotics is much easier.

If you stop after say, two repetitions on one day only, you might knock the infection back but it will probably return in a few days.

A hallmark of staph infections is they are very painful, far more than you would think from the look of them. When PC's infection was beginning we really couldn't see a thing but her finger was hot and red. Next morning we could see a small white dot (like a pimple head, but not raised like a head) and the are was red and swollen. She was crying from the pain. When it finally burst, it began to form what we now recognise as this typical pattern you get with strep & staph working together anaerobically - an open wound with what looks like a ring of white loose skin (like a burst blister) and which was increasing in diameter every hour. Under the soggy skin was pus. The wound even began to heal in the middle but the ring was spreading and the wound area remained very painful.

PC was put on oral antibiotics as well as topical.

Culturing this is tricky - a lot of pathology labs are automated and won't recognise this because it multiplies anaerobically. My microbiologist friend said to ask for the pathology to be cultured for strep and staph, aerobically as well as anaerobically.

When I had this I remember having to really nag for the pathology to be done this way but it did produce results which the doctor had not expected (and which proved the microbiologist correct). I was unable to take antibiotics, so I used the hot water method. We were on holidays and fortunately the unit we stayed in had a microwave oven. I would heat up a glass of salty water in the microwave, then walk around the unit with my finger submerged in the glass.

I was also suffering from the systemic effects of the infection - fever and general malaise. All from a sore on my finger!

It took about a week of the treatment regime but it did get better.

Now, to get back to the main question - is this particular infection truly impetigo? I don't know, I can't see it. It is possible it is not. It is also possible it is a staph infection trying to get a hold.

The original strategy stands. And while following this, make sure you use good infection control procedures (to avoid cross-contamination). This includes washing hands thoroughly before and after treatment, and disposing of any used swabs, band-aids etc.

Step 1) Cover it. Keep it covered when not being treated. This is to stop any possible spread.

Step 2) If possible, apply heat every three hours as hot as she can stand it - be prepared to increase the heat as she gets accustomed to it. Let her control the heat level, though.

Step 3) Dab on some hydrogen peroxide, making sure to get it into every part of the wound you can. If the blister is broken, remove any loose skin that you can (gently) and make sure you wet the area underneath with peroxide.

Step 4) Gently mop up the peroxide. Dab on whatever antiseptic you are using (including antibiotic cream, if it has been prescribed)

Step 5) Cover it again.

Step 6) After three hours, repeat from (2).

This should also work for MRSA, because after all, MRSA is simply staph aureus which just happens to be antibiotic resistant. That doesn't mean it's impossible to kill, only that it's difficult to kill with these antibiotics.

Example: you have two flies side by side. One is resistant to insecticides, the other is not. But if you swat those flies, they will both be just as easily killed with the swat.

So don't panic when you hear about MRSA unless it's in a hospital where you or a family member is planning to have surgery. You should have your own good immune protection against out of control staph, which is also protection against MRSA. It mightn't be perfect protection, but it's as good as you've got. And will probably be enough.

For most of us, when we get a staph infection it's most likely that the bacteria came from our own skin. This is unlikely to be MRSA. IN your daughter's case, the graze probably drove some of her own bacteria into her own tissues where they were not meant to be. There IS a possibility that the bugs came from the floor of the treadmill (and all the feet that walk on it). Again, no reason for it to particularly be MRSA.

As for seeing a doctor - if she's feeling well and you keep it covered, it's up to you. If it looks like it's spreading or getting worse, I would get it seen to. In the meantime, you could begin the regime with heat.

But you are the person on the spot - you need to make the decision.

Also, if this is definitely impetigo, I would be looking at her immune health, because she needs to build up her strength. Is she stressed? Not eating right? Not getting enough sleep? All these can suppress your immune system to the point where you can be more vulnerable to getting something like this.

Marg

[Lothlorien]

So, did you go? And the dx is????

I know I'm late on this, but I would avoid ER at all costs, unless absolutely necessary for anything. ERs are crawling with all kinds of sickness and if she didn't have MRSA, she could certainly pick it up at a hospital.

[slsh]

Sorry for the lapse time - home renovations are reaching volcanic proportions right now.

Diva woke up Fri with a much better looking knee. Blister was gone. I decided not to do ped since it was just so amazingly better and it's not oozing or warm. It was the reappearance of the blister Thursday night after 2 days of no blister that really had me freaked out. I think it's a friction burn from the silly treadmill.

I wouldn't have done an actual ER - we have an urgent care clinic kinda close that I would have taken her to.

It was just one of those really scary moments that freaked me out completely - I have just enough knowledge to expect the worst and be completely nutso about it, LOL.

I'm continuing the Neosporin at nighttime and having her keep it open during the day if she's not out playing.

Thanks you guys - I really appreciate the support, advice, and information!!

[susiestar]

Glad she will be able to keep the leg, LOL!!

I keep peroxide in a spray bottle to use on the sores I get. I works better than anything else. And I have tried everything.

With peroxide it works best if you spray, let it bubble, rinse, then repeat several times.

The spray bottle lets me apply a good coat, but not pour a ton of it down the drain (or my chest when I get the sores there!).

I am guilty of freaking out over kid stuff too!

Hugs,

[Abbey]

I got it as a teenager on top of poison ivy! Yup, what a pretty picture I was!

Beth, when my oldest was a kid, he was a radar for poison ivy. If it was out there, he'd find it and run through it, which was nearly on a daily basis. I swear he spent the first 10 years of his life looking red and blotchy. He'd get it on his arm or leg, scratch it, then touch his face. DON'T TOUCH THE FACE!!!

Abbey