URGENT-infection, new ped in just over an hour..

[smellyann82]

if anyone is able to help quickly, that would be great! ds is 14mo, no prior issues. last night, he was very upset, and seemed to be having some abdominal pain or something along those lines. he ended up falling asleep peacefully and he passed a bunch of gas in the middle of the night, so we thought it was resolved. this morning, however, i found spots of blood in his diaper, and his penis looks awful. his foreskin is red, with what looks like dried puss and a small area that was bleeding a bit. i've not had any experience with intact penis issues, so i'm wondering what this may be. i also suspect that urinating has been painful and that we misread the abdominal pain, as he was grabbing his diaper as well last night, although i'd imagine that could have been burning on sore foreskin OR urinary tract pain. any thoughts on what this could be, possible reasonable treatments, what to expect? we JUST moved, and are seeing a ped we've never seen before, which makes me very nervous, but i feel it is better than an ER or urgent care doc who may not know how to properly handle an intact baby. tia!

[Night_Nurse]

Does he have a fever? Has his fluid intake and urine out-put been about equal? Meaning, have you noticed smaller or less frequent wet diapers?
Has he been swimming or in bubble baths recently? Has anyone retracted him?
Does he retract on his own yet?
Whatever you do, DO NOT let your pedi retract him in any way! Stand over your son during the exam and if the Dr. wants to look, say you will be the one to handle the penis. too many Drs retract after saying they won't.

[smellyann82]

he swam in our baby pool yesterday. no retraction. i'm very nervous that she'll want to. should he best swabbed for infection?

[FaithfulOne]

At 14mo I wouldn't think he's anywhere near close to a retractable stage (my ds1 is 7 and still only partially retracts)
There have been times when my ds'd got similar issues, especially after swimming etc. I never panicked nor did I ever rush to a Dr....I would usually just let them be naked and put some anti-fungal remedy.
If you're super concerned or your ds is extremely uncomfortable then take him.

[smellyann82]

we're going anyway for a followup on a fractured clavicle. rough week for this little guy. i think i'm just going to tell her what is up. it looks better already. i bought some seventh gen disposables to try to keep it cooler and drier. he has a little heat rash on his legs and thighs too. he seems to not have quite as much discomfort as this morning, when he wouldn't even let me hold him.

[Night_Nurse]

If the doc. wants to prescribe antibiotics, personally, I'd request a swab for a culture (on the tip - they don't have to retract to do it) before I starting giving the antibiotics. If he has yeast, an antibiotic could just make it worse.

I doubt your kiddie pool was the culprit but you never know. Maybe just some naked time in the fresh air w/o a diaper might help.

If they want to do a urinalysis, they can go it via a bag instead of a straight catheter. This can be done without retraction!

I'm not trying to scare you and we never had trouble w/ our pedi, but I've read sooo many threads here where the pedi retracted despite being told not to, even w/ mama standing right there. Be very cautious.

As far as separation, most boys don't fully retract until they are older but some are retractable as early as infancy/toddlerhood. My youngest child was fully retractable by 2 1/2 yrs, so I assume he started the process around 1 1/2 (he never had any bleeding/discharge/pain that I'm aware of though but some boys do and it's normal).

Good luck!

[smellyann82]

we went to the appointment. she was, from the get-go, obviously not familiar with uncircumcised boys. she suggested that we circumcise after the issue clears up. she said it looks like bacterial skin infection. she prescribed an ointment. i thought about asking her to do a swab, but she seemed to really want to retract, and i didn't want to give her the opportunity. when she examined him i kept my hands right next to hers and when i felt she was going too far, i pulled his diaper back up. she seemed mildly uncomfortable with the whole thing and after the circumcision comment i sure as heck wasn't going to encourage her to do anything more. so, wwyd? use the bacterial ointment? there's dry puss still and a little blood, all on the surface..clearly a skin issue. does it sound more like something i should use an anti-fungal ointment for? do nothing? it is definitely still very sensitive, and he won't stop grabbing at himself, and therefore irritating it and getting upset if he has a diaper off. i am going to keep him in disposables for a few days, on loosely, which are deifnitely more breathable than our normal prefolds and bummis wraps, which i think we'll strip this weekend to make sure it isn't a diaper issue.

[chaoticzenmom]

Did she look into the abdominal pain? Did she check for a UTI? It bothers me that she jumped on the foreskin first seemingly neglecting the abdominal issue. You handled it perfectly though.

[smellyann82]

oh, i don't think that there is an abdominal issue. he's been doing the same thing all day, but seeing what his skin looks like, it is pretty obvious now that he's pulling at his belly, trying to get his hand into his diaper to try to sooth himself. he's had no fever or problems urinating, so she thought no on the uti.

anyone have thoughts on a comfrey bath for this?

[MCatLvrMom2A&X]

There are some tips on dealing with separation pain in this thread.

[smellyann82]

opinions helpful-would you use the antibiotic cream? i really don't have another doc here i can take him to for a swab, other than our ER and i just don't trust them to not hurt him. it's still looking rough today, almost 48 hours later, and still bothering him. i have no way of knowing if it is yeast or bacterial. oh, i wish we had a circ-friendly doc here.

[eepster]

What kind of antiboitic cream is it? Some, such as neosporin, should not be used on genitals.

[Night_Nurse]

Where are you located? You could always ask other MDC members in "Finding Your tribe" if they know of foreskin friendly doctors in your area. Also, I believe there is a list of foreskin friendly doctors in one of the "sticky" posts at the top of the forum.

My feeling on the ointment...an antibiotic ointment is only going to make yeast worst. However, if your son really does have an infection, I hate to make him wait a few more days before you start treatment. What is the name of the antibiotic? Have you tried any over-the-counter yeast cream yet? You can even buy that now at the dollar stores or any pharmacy. It wouldn't hurt to try a dose or two of it and see if it works. However, if you start the antibiotic, you really should finish the entire round of treatment unless your son has a bad reaction to it or if the Dr. says to stop it before finished.

I'm not sure your son really has an infection. I'm not sure it's not some kind of normal separation discomfort. Have you read the sticky about that (not trying to be snarky, we've had several "problem" threads lately and I'm not remembering which one I've posted the separation info to or not)? Since he doesn't have a fever and he's drinking and peeing okay, it might be fine to take a wait and see approach. But that is what I'd probably do if it happened with my kid. You know what is going on with your son and you have to follow your gut feeling on what is best for his situation. Have you tried any natural remedies? Does he like to soak in the bath? While my son never had any penis issues, I know how hard it is to see your baby suffer when he's uncomfortable. I've read that breastmilk can help heal and also baking soda baths can be good too. I'm sure there are other natural remedies for comfort.

Question? Are there OTC yeast diagnostic tests?

[smellyann82]

thanks for all the suggestions and resources, everyone, it has been much appreciated! the issue has cleared up, but i have a couple of questions. i used the antibiotic cream for a day (not neosporin, it was a scrip) and the next morning it was much better, and the doc just prescribed as needed. that was yesterday, and today it is pretty much back to normal. so, question is, can a separation issue last for more than 24-36 hours. from start to finish this lasted more than 4 days, which is why we saw the doc friday, it had already been 48 hours since the issue began. also, i am curious to know if there is an otc yeast test, for future reference. dd had an ongoing issue with yeast diaper rashes, but on the butt, it is much easier to identify. thanks again, you all were so helpful and quite empowering!

[Anastasiya]

Originally Posted by smellyann82

thanks for all the suggestions and resources, everyone, it has been much appreciated! the issue has cleared up, but i have a couple of questions. i used the antibiotic cream for a day (not neosporin, it was a scrip) and the next morning it was much better, and the doc just prescribed as needed. that was yesterday, and today it is pretty much back to normal. so, question is, can a separation issue last for more than 24-36 hours. from start to finish this lasted more than 4 days, which is why we saw the doc friday, it had already been 48 hours since the issue began. also, i am curious to know if there is an otc yeast test, for future reference. dd had an ongoing issue with yeast diaper rashes, but on the butt, it is much easier to identify. thanks again, you all were so helpful and quite empowering!

In our son's case, yes, the separation issue lasted almost a good week. It cleared up on its own.

[smellyann82]

another question, too, for anyone still reading can separation issues happen more than once? his foreskin is definitely not retracting, not that i've tried, so when more separation happens might we see more of the same?

[MCatLvrMom2A&X]

It can and usually does for most boys. Full separation usually takes months or in many case years.

It may happen without you ever knowing about it or he may get a bit sore from time to time. It is hard to say for sure.

[eepster]

DS had signs of separation twice (nothing dramatic, just some smegma in his underwear which I thought might be ice cream at first.) The second time was a few months after the first.