Bens I am glad your son is fine. I am on my phone and can't see the picture really well but I would have guessed fire ant bite.
Kemorr I totally agree with you on unnecessary testing.
I would have totally thought fire ant bite. I've had them before and they are super painful, though usually the ants are in swarms so he would be lucky to only get one. I never would have thought infection (let alone staph) which is really scary. Lucky you got him treated!
Glad he is fine -my DS had a cut on the bottom of the foot that became infected while we were on a camping trip (the cut happened while we were camping). The red around it kept growing and was extending up his leg -there was really no first aid station at the campground even though they claimed there was. I purchased alcohol and some bandages and we did out own camp surgery on it -well, DH did and it ended up being fine. I did take him in to have it checked out, but after we did our own thing the red started receding.
Maybe your DS stepped on something that didn't really bother him and it just created enough of a hole for something icky to get in.
mcgwigan- in your situation I would have definitely done what you did. But since I'm not a doctor and it clearly hurt him very badly we just took him to the ER and let them do it. We have a pediatric ER so we were in and out.
As for the culture, I had no idea they'd do that but they insisted so we let them. I'm also curious exactly what type of infection it is.
FWIW, I think culturing every.single.minor infection that walks through the door a total waste of medical $$ and a large part of why health insurance in this country is so out of control - needless tests. By far the majority of minor infections will respond to a good broad spectrum antibiotic (topical or oral - which they have already given you and you are already using, pre-culture results) and if no response is seen within 48 hours, then a culture can be performed (when plenty of pus will still be available for culture if empirical treatment has failed). Mostly they're just culturing it because they don't want to be sued. They might use the antibiotic resistance argument, but that argument doesn't hold water when they give you the antibiotic BEFORE the results.
This is the exact attitude that has lead to antibiotic resistance and superbugs. Yes, with children I would agree to start a broad spectrum depending on which type of staph is more predominant in their community. (In adults, lancing w/out antibiotics can be sufficient in a minor infection.) The Infectious Disease Society does recomment cultures (usually just the first abscess if this becomes a recurrent issue.) It is completely irresponsible prescibing to be routinely throwing broad spectrum antibiotics around.
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This is the exact attitude that has lead to antibiotic resistance and superbugs. Yes, with children I would agree to start a broad spectrum depending on which type of staph is more predominant in their community. (In adults, lancing w/out antibiotics can be sufficient in a minor infection.) The Infectious Disease Society does recomment cultures (usually just the first abscess if this becomes a recurrent issue.) It is completely irresponsible prescibing to be routinely throwing broad spectrum antibiotics around.
But, Pookie that is exactly what they're doing. They're prescribing an antibiotic for use days before receiving the culture and sensitivity results. The purpose of a culture and sensitivity is to choose the right antibiotic for that particular bug, but by not waiting for the results and prescribing an antibiotic in the interim they're completely invalidating the antibiotic resistance argument. You stated that you'd use your clinical judgement based on which type of staph is more predominant in their community to treat prior to the results becoming available. And that's what you're taught to do - use clinical judgment. So, I'm saying that medical personnel should continue to use that clinical judgment, do exactly what was done and what you stated you would do but HOLD OFF ON THE TEST for 48 hours to see if your clinical judgement is working or not. If you have no response to treatment, you can do a test at that time. You've not "thrown antibiotics around" anymore than what these ER docs did or what you've stated YOU would do, because with the exception of holding off on the culture, the treatment strategy was identical (empirical treatment based on clinical judgement). FWIW, I also recommended using a very low grade, topical antibiotic for a couple of days, whose over the counter accessibility and use by every man and his dog isn't going to affect any creation of superbugs by using in a fashion I recommended. Do you recommend every pediatric ear infection be cultured? No, of course not. you prescribe based on a knowledge of the common bugs that cause ear infections and then if that treatment fails you go to the next step. You also don't use your "big guns" in empirical treatment. The infectious disease society may recommend all first abscesses be cultured, but then the cancer society recommended all men receive a yearly PSA and recent research has indicated that annual PSAs are doing far more harm than good. And that every child that receives a minor concussion being given a CT scan is at greater risk from the radiation by receiving the CT than from any risk posed by a minor concussion. People in the medical community are often the last to realize that perhaps all this rampant testing isn't always necessary.
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Originally Posted by kemorr
