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#1 of 13 Old 01-24-2007, 05:45 PM - Thread Starter
 
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DH and I just noticed a red spot on the bottom of (20 month-old) DS's foot last night that's about the size and shape of a medium children's band aid that had what looked almost like a blister on it or possibly was a splinter. We lanced it, but found no splinter or anything. It was an odd shape so I didn't think it was just a blister, but he had no fever, so we waited until this morning to take him to the doctor. Our doctor is pretty holistic, and he immediately prescribed Keflex for him. He said he has Cellulitis.

After doing a little research I thought it might be from an insect bite, but now I'm wondering if it's from the little bit of foot fungus he has between his toes. That possibly when standing him up after a diaper change some feces got into the dry skin. The redness does not start at the toe area (it's more towards the heel from the bottom of the foot going up to toward the ankle), but if I'm reading correctly the information that I've found online it doesn't always start at the exact site of the infection?

I am completely comfortable with the diagnosis and treatement with Keflex (and probiotics when we're done), which is what's indicated for this type of infection. I'm just wondering about the course of the treatment. Does it get worse before it gets better? And, wondering what might have caused it, particularly the issue of whether or not the redness starts at the actual site of infection? There does not seem to be anything in the "blister" such as a splinter or glass.

I'm just a little thrown by it as I didn't see anything wrong with him yesterday morning, and by last night it looked horrible. If he'd had a fever then we'd have taken him to the ER last night. I guess my other question would be what causes foot fungus in a toddler? He's had this "forever" to varying degrees. We've used a tee tree ointment which has kept it at bay, but never made it go completely away. He has been in physical therapy for over a year, and just started walking at 18 months. So, he's usually been barefoot or in socks inside. I thought "athlete's foot" was caused by sweaty feet?

Thanks for any advice anyone can give. While he hasn't even had a fever, it's still a littly scary.
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#2 of 13 Old 01-24-2007, 07:58 PM - Thread Starter
 
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#3 of 13 Old 01-24-2007, 09:49 PM
 
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Originally Posted by Imvishta View Post
Our doctor is pretty holistic, and he immediately prescribed Keflex for him. He said he has Cellulitis.
I am surprised he doesn't have a fever???

In this case I would probably go with the antibiotics also.


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... (and probiotics when we're done)
This is the only thing I would do differently, I would start with probiotics NOW. And I would keep it up for at least a year or longer. The flora is not replaced as easily as it is destroyed by antibiotics.


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Does it get worse before it gets better?
NO, I don't think so, it should start getting better within a day. If not, I would call the doctor back and ask him.


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I guess my other question would be what causes foot fungus in a toddler?
Sugar in the diet? Sodas, candy... wrong nutrition? I don't know how your diet is, I am just saying some things that could be the culprit.


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He has been in physical therapy for over a year, and just started walking at 18 months. So, he's usually been barefoot or in socks inside. I thought "athlete's foot" was caused by sweaty feet?
Or contact with the fungus such as in the locker room or at the physical therapy. ??

I hope it starts to heal quickly. Diet is the key to keeping his athlete's foot under control. Is he still nursing? Is he vaccinated?
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#4 of 13 Old 01-24-2007, 11:36 PM
 
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Is the doctor sure of the diagnostic? Cellulitis is serious, it's an infection of all the layers of skin and spreads rapidly. Like all infection, there should be a fever.

I would put a topical antibiotic cream (polysporin) and not pierce the skin. If it gets worse I would definitely seek medical attention.

Other things it could be is hand/foot/mouth disease (causes blister to form on the bottom of the feet, sometimes on the hands and inside of mouth too).
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#5 of 13 Old 01-24-2007, 11:42 PM - Thread Starter
 
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I am surprised he doesn't have a fever???

In this case I would probably go with the antibiotics also.



This is the only thing I would do differently, I would start with probiotics NOW. And I would keep it up for at least a year or longer. The flora is not replaced as easily as it is destroyed by antibiotics.



NO, I don't think so, it should start getting better within a day. If not, I would call the doctor back and ask him.



Sugar in the diet? Sodas, candy... wrong nutrition? I don't know how your diet is, I am just saying some things that could be the culprit.



Or contact with the fungus such as in the locker room or at the physical therapy. ??

I hope it starts to heal quickly. Diet is the key to keeping his athlete's foot under control. Is he still nursing? Is he vaccinated?

I did call the doctor back and spoke with his nurse about when to start the probiotics, but they said that there was no point in starting them until he'd finished the antibiotic? I chose this doctor because he does not push antibiotics and is known in this town for being holistic. And, I think he's the only one who will see children who aren't vaccinated. DS is vax'd, although if I knew then what I know now I would have probably delayed some. (The second round scared me a bit.) And, he has not nursed since around six months. Huge problem there for several reasons that I did not know about ahead of time (PCOS, DS's torticollis). Our doctor is from Cuba where it's practically law to nurse and is soooo pro-nursing that when I told our playgroup that he told us to supplement several of the mothers actually gasped!

As far as diet otherwise... we've had problems getting DS to eat solids and are going for an evaluation on the 2nd. Big gagging problem. So, he eats third stage baby food. He's never even eaten a piece of cake! Or even the icing. (I wish he'd eat a piece of cake.) No conventional junk food. Not even a Cheerio or Goldfish or anything like that. No juice and especially no sodas, for sure. Only recently has he started gnawing on the Gerber Biter Biscuits, but doesn't actually eat the whole thing. He has started eating about a cup of yogurt (e.g. Dannon) with sugar in it a day, for which I'd like to find a more healthful alternative. We're trying to keep his caloric intake up, but that's really hard to do with what he eats. However, based on what I see/hear other children eat I don't see how any child eats the amount of calories they're supposed to be eating. I think he's supposed to be eating around 1,100 calories a day. He's such a little guy I feel like we're forcing him to eat so much! Sigh...

I didn't even think about him getting the fungus at therapy. I've just thought it was so odd. Now that you mention it... One day when he was down on the floor in the waiting room he got so filthy that the therapist took him to her supervisor's office where they photographed his hands, feet, and legs to show the appropriate people how much they needed to either have their carpet cleaned or get new carpet. Holy cow! DH just said, "That could be it!" We never even thought of that! All this time I kept thinking "Why does this keep coming back?" It's not like an older child running around with sweaty feet. I'd just gotten to the point where I was going to ask for a prescription or something. I'd read about... uh... something violet? (I'm too tired to remember.) But, also read that it can tattoo on broken skin so was hesitant to try it.

I'm rambling... I think I will go ahead and start the probiotics. I mean it certainly can't hurt. Whenever I take an antibiotic I always take Diflucan right away, so I kind of wondered why we would wait. (I've taken way too many antibiotics over the years, which is another reason I chose this doctor. I don't want DS's system messed up like mine. When we all had a virus a few months ago, he and DS got well in a few days, but I just stayed so sick.)

So, the probiotic the nurse mentioned to me is called Culturell. Have you heard of that one? Any other suggestions? I've always taken Difulcan or acidophilus tablets.

Thanks again for mentioning the connection between the fungus and physical therapy. That seems so obvious, you know. But, when your child is getting fitted for a helmet or won't walk a little fungus seems so minor. I guess it's really not, though!
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#6 of 13 Old 01-24-2007, 11:54 PM - Thread Starter
 
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Is the doctor sure of the diagnostic? Cellulitis is serious, it's an infection of all the layers of skin and spreads rapidly. Like all infection, there should be a fever.

I would put a topical antibiotic cream (polysporin) and not pierce the skin. If it gets worse I would definitely seek medical attention.

Other things it could be is hand/foot/mouth disease (causes blister to form on the bottom of the feet, sometimes on the hands and inside of mouth too).

I took a look online at a lot of sites about it today, and it does look like cellulitis. And, it came on quickly, as I saw nothing yesterday morning. The information I got online said that if there is no fever to see your doctor that day, but if there is (maybe above a certain level) to go to the ER. So, the only reason I didn't freak out last night was that he did not have a fever. There were many different appearances in the photographs I saw online, but did find several that look like DS's foot. Here's one that is of a leg without the blister: https://courses.stu.qmul.ac.uk/smd/k...es/slide32.jpg DS's foot looks like this in terms of intensity, but is on the bottom of his foot and is only the size of a band aid. And, it had one "blister." I'll check out some info on Hand, Foot, Mouth, and we have some friends whose son had that so we can check with them, as well.

Sounds like the child you were babysitting had this much worse than my son! Your description in the older thread sounds really frightening. That's so strange, and to not know what causes it must have been rough on his parents. How would you know what to avoid in the future?

Thanks for your PM, too.
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#7 of 13 Old 01-25-2007, 12:01 AM
 
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So, the probiotic the nurse mentioned to me is called Culturell. Have you heard of that one? Any other suggestions? I've always taken Difulcan or acidophilus tablets.
I am not familiar with the probiotics he suggested but it probably is for his age.

Kids need different probiotics than grown ups because their intestinal flora is still different.

I wish I could help you more. But that's all I can do, suggest what I would do. And *I* would deffinitely start the probiotics now.

I would not give it at the same time as I would give the abx. I'd give it in between.

http://www.culturelle.com/

Gee, I don't know if this is for kids??
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#8 of 13 Old 01-25-2007, 12:08 AM
 
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This one is deffinitely for kids and most health food stores carry it -

http://www.jarrow.com/product.php?prodid=201

You can ask at the health food store whether the one the doctor suggested is for kids. I would make sure. Doctors don't know a lot about probiotics. It's a new concept to them. They are only used to antibiotics. So, if it's not the right one, I would not be surprised. :
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#9 of 13 Old 01-25-2007, 12:11 AM
 
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Cellulitis is just a catch-all term for any skin infection. My DS had a couple spots of staph aureus last year and they called it cellulitis. We just used an antibiotic ointment - mupirocin. That cleared it up and we didn't have to fill the Rx for Keflex. Did your doctor do a culture on the infection?

I've never used Culturelle, but I've heard good things about it here at MDC.

Tis the season, for hot apple cider!
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#10 of 13 Old 01-25-2007, 02:30 AM - Thread Starter
 
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So, don't give the probiotic at the same time of day as I give the dose of the antibiotic? The antibiotic is three times a day, and the probiotic they recommended is once a day. It's not specifically for children, but their site does say it's safe for children. If I give the antibiotic every 8 hours at what point should I give the probiotic?

About the culture... He did not do a culture. Just examined it. We had lanced it with steralized tweezers last night as we thought he probably had a splinter. So, he diagnosed it based on the appearance of the inflamed area and the puss from the abcess. I'm assuming that's the basis of his diagnosis...

One bit of advice for anyone reading who might experience this with their DC is to draw a circle/line around the inflamed area to see if the area spreads. We didn't do that last night, but I did that today. It has not spread nor gotten any more inflamed.

Based on some friend's experiences I feel pretty lucky we made it to 20 months without an antibiotic. And, since he does have the cracked skin around his toes which would be an easy avenue for a bacteria to enter, and he is a tough one to change a soiled diaper, it is not unlikely that some feces could have entered through that means. If he didn't have that long-standing problem (has come and gone, and is at a bad point now) I'd be more likely to re-think the oral antibiotic. I've really had to think through all of this today (what, how) and think that's the best course. And, to treat the fungus more aggressively, and talk to the physical therapist about keeping his shoes on while there.

Oh, and the other treatment for fungus I tried to remember before was gentian violet. It was on the tip of my brain, but my brain is a bit tired tonight. :
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#11 of 13 Old 01-25-2007, 12:03 PM
 
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I can't view the link

nak
i wouldn't worry about taking probiotics with antibiotics, my doc has always reccommended taking pros when on antis.

i hope your son is getting better.
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#12 of 13 Old 01-26-2007, 01:27 PM - Thread Starter
 
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Thanks for the advice. He's had exactly two days of the antibiotic (six doses), and I've just noticed the redness start to go away, just as expected. And, no side effects so far. Only DH and I ended up with the upset tummies.
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#13 of 13 Old 01-26-2007, 03:41 PM
 
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You give the probiotic in between the antibiotic.
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