Two weeks ago Dear Daughter told us that her "ear hurt", so we took her to the pediatrician and sure enough, ear infection in the right ear. Since she'd had Amoxicillin in April for a double ear infection, the pediatrician put her on Augmentin this time. As I understand it, Augmentin is like Amoxicillin but augmented to be more effective.
After about five days on Augmentin, DD came down with a fever. I totally dismissed her fever and accompanying cough because our DS had just battled a fever and cough the previous four days. In any case, after a night and most of a day with a fever, DD woke up from nap time with what looked like hives:
Because neither of our kids had ever had a rash that looked like this, I took her to see her Doctor.
The diagnosis at this point was viral hives, presumably from the virus she caught from her brother. The pediatrician ruled out a reaction to Amoxicillin because she assumed that DD would have reaction the first time she'd been given the drug. I know now that this is not necessarily true. Our doctor told us to stop giving her Augmentin because, whatever was going on, it clearly wasn't helping her ear infection. Instead we were told to start her on a drug called Omnicef.
In any case, into the night and into the next day, DD started to get worse and worse:
Benadryl did nothing to ease the itching or the swelling. Oatmeal baths were nice temporarily, but ultimately annoyed her. Her skin turned fire engine red and raised up into welts. Her eyes gradually disappeared. She also had a high fever this whole time and we were giving Ibuprofen for that. She had no trouble breathing at all, fyi. Now, I was told she was having a "allergic" type reaction to a virus, so to my knowledge all of this was to be expected.
After nap time on this third day, DD woke up with bruises in amongst the rashes. Now, I've talked to my DH about this sort of thing before and I knew it wasn't good. So I called our pediatrician back and this is the conversation we had:
"Hi, this is Me, we saw you yesterday for a rash? It's gotten a lot worse and her face it totally swollen. But that isn't really what concerns me. She just woke up with what looks like bruises all over."
I was waiting for our Doc to reassure me and say that was what she expected to see. Instead she said, "Um, yeah....she could be going into blabbedy-blabbedy-septicemia. You need to get her to the ER now. If she needs something I can't provide, I'd rather she be there instead of here."
"Oh. Okay, well I'm going to go now."
"How far away are you from the ER?"
"I'm going to take her to Children's, we're maybe half an hour away?"
"Okay, that should be fine."
"Okay, thank you, will you call ahead?!"
"Yes, they'll know you're coming."
"Bye."
So, even though DD was responsive, eating and drinking some, and breathing fine, now I'm terrified that she's going into septic shock and is going to die before the day is out.
My husband was in some inane (so it seemed at the time) Life Support Class for his job at the hospital and I couldn't get a hold of him. I called my Mother-In-Law instead, a saint in jeans and T-shirts, and she dropped everything to meet us at the hospital. I was bawling as I buckled the kids into their car seats. Every time I looked at DD's legs, all red, splotchy, and bruised, I was reminded that her little body might be giving up some invisible fight.
Through my tears, I called a number DH had given me for the department he usually works in at the hospital. Some poor Respiratory Therapist tried to understand me through my sniffling. She worked some magic and figured out where my husband was. I found out later I used the wrong acronym to describe what class he was in and there was a lot of confusion. So the message that "his wife is looking for him because she has to take their daughter to the ER" got sent through a lot of people before it made it to my husband. In real life, Telephone works pretty well!
In any case, I calmed down when we got to the Children's Hospital Colorado Urgent Care and was relieved to see that we weren't the foremost priority. That calmed me down because I know that they rush the most critical cases right in. Apparently our warning signs weren't that terrifying. My poor son was tired (nap time) and hungry. I had thrown an energy bar and chips at him for lunch before we ran into the truck.
My mom-in-law and Dear Husband arrived shortly after we were admitted into a room. People underestimate how nice it is just having someone there with you. They don't even have to anything, it's just nice that they're there, you know? So my mom-in-law brought comfort, reassurance, and love but also books, food, and cuddles. :) Priceless.
When DD saw her Grandma, she immediately asked for her, "Hold you, me! Hold you, Grandma!" DD gobbled down her first solid food for the whole day, Grandma-Approved Goldfish crackers.
Shortly after seeing my sick kiddo, the Physician's Assistant and the Doctor working agreed that she had something called Serum Sickness.
PubMed Health says that Serum Sickness is "a reaction similar to an allergy. Specifically, it is an immune system reaction to certain medications..." That's so much better than having blood poisoning and dying! Seriously, that's not sarcasm, that's a ton better.
Continuing on: "During serum sickness, the immune system falsely identifies a protein in antiserum as a potentially harmful substance...The result is a faulty immune system response that attacks the antiserum. Immune system elements and the antiserum combine to form immune complexes, which cause inflammation and other symptoms...Unlike other drug allergies, which occur very soon after receiving the medication again, serum sickness develops 7 - 21 days after the first exposure to a medication."
From what I was told, it's totally possible that her first exposure to Amoxicillin was when her body developed antibodies. This second round of Amoxicillin (Augmentin) triggered the immune response. I chafe at the description saying this is a "faulty" response. Honestly, we humans are so prideful. Amoxicillin is man-made and totally unnatural. Yes, it helps us and is an amazing drug, but it's not supposed to be in our bodies. I think DD's immune system is just better than normal at identifying invaders. :)
The super-nice staff answered all of my questions and reassured me over and over. The bruising was normal and caused by the severity of the rash. The rash was so harsh that it bruised itself! We were told to take her off of any drugs for her ear infection. The Physician's Assistant there said a) the infection didn't look horrible and b) it wasn't worth the potential complications if DD was still reactive. More variables, you know. Hopefully the ear infection would clear up on its own.
We were given steroids to put her on for four days to calm down her immune system. Steroids? My baby!? I repeatedly asked about the risks versus the benefits; so far the steroid has made a remarkable difference in her symptoms. After one dose of steroid at the hospital, you could kind of see her eyes again and the redness on her face started to recede. After three doses of steroid, she looks mostly like herself again and the itchiness has largely disappeared. This is after one dose of steroid:
Her hands and feet are swollen (it was difficult for her to walk) but she looks ten times better.
At our follow-up with someone in our pediatrician's office, I asked over and over whether they agreed with the diagnosis. This doctor did. I asked if we should get her tested for other drug allergies. The doctor shook his head. "Oh, no, she won't be allowed to have any of the drugs in that family. Penicillin, Augmentin, and the cephalosporins,Omnicef.."
I nodded my head, but I don't know what cephalosporins are. Google tells me that she can't have:
- Penicillin VK
- Penicillin G
- Dicloxacillin
- Oxacillin
- Nafcillin
- Amoxicillin
- Ampicillin
- Augmentin (amoxicillin/clavulanate)
- Unasyn (ampicillin/sulbactam)
- Zosyn (pipercillin/tazobactam)
- Keflex (cephalexin)
- Ancef (cefazolin)
- Ceftin (cefuroxime)
- Cefzil (cefprozil)
- Omnicef (cefdinir)
- Vantin (cefpodoxime)
- Many other antibiotics beginning with “cef-“ or “ceph-“
Today she looks better still, but she still has a ways to go before she's 100%. And come to think of it, my Dad has a similar penicillin-family-of-drugs allergic reaction. Genetics might have something to do with poor DD's reaction. Since this has happened, I've heard from several friends and acquaintances who have had or have children who had the same reaction. Not so uncommon. The wonderful woman who helped me get my library books today has a son who has had serum sickness and can no longer have these drugs.
Anyway, I'm going to stay home, breathe deep, and just thank God that both my kids are doing okay.
Oh honey!! Here's a fellow mom hug from MN! I'm so sorry you are your sweet little girl have been through so much this week :( But Praise God that she's on the mend
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