Serum Sickness

The above pictures were taken before things started to get really bad. In the past they had never gotten worse than this. Which is still miserable.

Life decided to start the new year off in a manner we would prefer to avoid in the future. It all began back on December 23 when I noticed that Justin appeared to have a sinus infection. Since Jeff had the day off, we decided to go see the doctor before the holidays when everyone would be on vacation. The pediatrician confirmed the infection and told us he had fluid in both ears. Had we not come in when we did, he probably would have ended up with a double ear infection on top of the sinus infection. Pleased that this scenario had been averted, we promptly picked up his antibiotic and proceeded to administer it to him.

Fast forward 7 days. On New Year's Eve I was scheduled to work a short day shift. I woke up to see Justin standing by my side of the bed, asking about breakfast. I noticed at that time that he had two tiny spots on the back of his neck. I immediately recognized them as hives and pointed them out to Jeff, asking him to help keep an eye on them. Just three hours later they had grown in size and spread to his arms, legs, back and stomach.

While I was at work Jeff called the on-call nurse and asked what we should do. We felt that it was the antibiotic causing the problem and also wanted an option other than Benadryl to give him since it typically is ineffective. She pointed out that an allergic reaction to the medicine would have already happened by this time, not seven doses in, and that we could administer topical cream to help with the itching.

By the time Jeff and the kids picked me up from work, Justin was flushed, and the spots had spread even further. His hives follow a very predictable path that begin with a small red dot, that then grows bigger, then they a whiten into halo shape in the center. The cumulative result makes it appear that he's lost a battle with an angry octopus. They soon raise up and resemble welts, and merge with other hives until it's actually hard to see unaffected patches of skin. Then they usually begin to fade back to normal from the inner part to the outer. At this point in the story we were at the angry octopus battle stage.

That evening Jeff and I made the decision to discontinue the antibiotic despite the nurse's recommendation. We also stopped the Benadryl and moved on to the medication the ER prescribed during the last outbreak of hives. His hives continued to worsen, but he had no trouble breathing so we decided to see if the medicine would calm them down (we know hives take a couple of days to subside). Each day it seemed that he was on the mend. The angry welts were fading and we felt that it was only a matter of time before things would be back to normal. We were wrong. Monday passed with us shaking our heads as we watched him worsen, then seem to get better, then worsen again. We didn't want to talk to the on-call nurse again. We knew we would be told to keep him on Benadryl and cream until he got better, or until we felt we needed to take him the ER. If he needed to see someone and it wasn't life threatening, we wanted his pediatrician to see him. She has never seen him with hives because it always happened after hours. She's also very good at listening to us and not assuming that we don't know what we're talking about since we lack medical degrees.

Tuesday morning, Jeff headed back to work while the kids and I slipped back into our regular weekly routine. I noticed Justin was having trouble walking. He shuffled from one place to the next, and asked me to hold him and complained of things hurting. I noticed dark bruising around his upper legs and lower abdomen as I dressed him. I checked his temperature and was shocked to see a low fever of 99.8. I called the doctor and scheduled an appointment immediately. Jeff came home to stay with Norah and the little baby I watch during the week, and Justin and I headed out.

By the time we arrived at the doctor's office Justin's fever was up to 102.4 and he looked even worse than he had that morning. The pediatrician took one look at him and diagnosed him with serum sickness. She spent a great deal of time with him looking over all the spots and bruises, and asking if it hurt to move. She explained that serum sickness is a stage three allergic reaction to an antibiotic and that it was VERY unusual for someone to have it as a result of the antibiotic omnicef that he was on.

We already know that he's allergic to penicillin so this means that there is only one type of antibiotic that we can give him now. He was given a shot of steroids while we were in the office, then we waited while they made sure that he wasn't going to react to that before we went home. We left with instructions on what to look for in the event that he reacted in a negative way once we got home. We scheduled a follow up visit for that Friday and headed home.

Justin looked terrible and no pictures taken can truly capture how bad off he looked. Jeff Googled Serum Sickness (we were warned not to panic) and was amazed to see that Justin had almost every symptom and that it typically starts 7 days into an antibiotic treatment. He has been given oral steroids for the remainder of the week and we are watching him closely to ensure that he really is on the mend.

That night he was miserable, tossing, turning and scratching, trying to get comfortable. He finally settled down at about 7 AM to get some real rest. Since then he's been doing much better. With only a swollen face and some residual bruising, he's on his way to being his old self again. The side effects are making life interesting for the rest of us as we watch him literally bounce off walls and run in circles, but we are thankful that he is improving so quickly.

Once again the lesson we learned early on in our parenthood is that sometimes medically untrained parents really do know their babies more than professional doctors and nurses.