Did anyone have little ulcers on a bruise?

Dougie had an accident at school on Thursday where he fell and knocked his shin on a bench. He had an enormous bump with a smallish graze in the middle. Over the weekend, the swelling has gone down quite a lot and the bruising has come out. The bruising extends most of the way around his calf.

I am a bit worried because he has some very small ulcers forming around the graze in the middle of the bruise. The ones he had this morning have scabbed over but he has some new ones now. Is this just because of the extent of the bruising, or is it something he needs to see the doctor about? Any thoughts gratefully received.

Thanks, Ali

It sounds like serum which keeps the wound moist so that it heals properly. Dried serum is what forms a scab. If it looks infected, ie oozes pus then he may need antibiotics otherwise I'd keep it covered with a dry dressing and wait.

Just my opinion though!

Hmmm, you might be right. I was thinking that it wasn't that because its not actually where the scab was to start off, but on the really bad bit of bruise around it. Anyway, it doesn't seem to have spread to anymore areas this morning so I am just leaving it for the time being.

Thanks for the reassurance Ann

OK, things going from bad to worse......maybe I should have listened to my first instincts. (Its not at all your fault tho Ann, because I was all too happy to be not consulting the doctor)

Dougie's leg has been hurting him more and more over the last 24 hours, so this evening I took him to the GP, got sent straight to the hospital, and their current estimate is that he will be there for 2-3 days. He had a mega strop when they told him he would be in overnight (and there was me thinking that he had got over toddler tantrums!). I think it would be fair to say that he is NOT HAPPY.

They think he has an infection from the fall he had last week so he is receiving IV antibiotics. Its a strange coincidence because I had cellulitis a few months ago and thats what they think he has too.

His count can't be high either because he now has bruising from the blood pressure cuff!

Ali

Things are still not going great. Dougie has been in hospital since Wednesday evening and they have said that its unlikely he will be released before Christmas Day (if then). He has been in quite a lot of pain, but they gave him codeine today which seems to work better than paracetemol. His count today was 9 which I guess is marginally better than 5 on Wednesday evening when he was admitted. So anyway, we are running around trying to rearrange things to accommodate Christmas at the hospital if thats what it comes to.

Just a warning here. Dougie's infection is apparently really bad because of the pools of blood left by the bruising he had. So if you ever get a bruise and an associated graze or cut, please treat it seriously and keep it clean etc. because I wouldn't want anyone else to go through this.

Hope you all have a great christmas,


Ali

Oh, Ali - I'm so sorry to hear all this. I haven't been on in a few days and was just. checking in. It sounds like you've had quite a scare. I hope that Dougie recovers quickly and am keeping my fingers crossed that he's out by Christmas. If anyone can will himself out of there it's Dougie! Tell Dougie that his friends across the pond are pulling for him. Nobody wants to spend Christmas in the hospital but Dougie will definitely have some good stories to tell when he returns to school.

I've never heard of the pooling blood making the infection worse and that's good to know. Hang in there and I hope that Dougie is cleared soon!

Ali,
I was thinking of your family, I hope you had a great Christmas even if Dougie was in hospital and I hope that he is better soon, he sure has some drama's in his young life.

Milly and Beth, Thanks for your kind thoughts - they obviously worked because Dougie finally made it home on Christmas morning. We had a lovely day, with dinner courtesy of a friend who (recognising that we hadn't had time to shop properly) invited all six of us round to share her turkey. Dougie has a prescription for antibiotics for the next fortnight and has to go back to the hospital tomorrow to get his leg checked. Its still quite hot and painful, but seems to be slowly improving.

Milly, too much drama in my opinion - I am hoping for a much more boring 2012!

Ali

Wow Ali! I am so sorry Dougie had to go through this just before Christmas! Glad you all made it home Christmas morning! Praying for a speedy recovery and for the pain to go away quickly! Not sure what ulcers are on a bruise but here it almost sounds like it would be referred to a staph infection (MRSA) which is common but very dangerous in athletes if they dont treat quickly enough. I hope you have an uneventful 2012 as well and hope Dougie's platelets go to a safe level so that bo worries have to occur. Have a Happy New Year? (If you have one there on Jan 1st)

Thanks for the good wishes Pauline. Dougie is getting better slowly. We went to the hospital today so that they could review progress with his leg - it is still a bit swollen and hot, but they think that thats the inflammatory process from the bruise rather than there being any remaining infection. Not quite sure I understand what the inflammatory process is, but never mind!! Fifteen days on, the bruise is still immense - it covers all the front of his calf, and it actually meets up round the back! He is still limping a bit, but not as much as before. So hopefully when all the kids go back to school next week, he will be good to go back too.

I have a couple of questions

a) has anyone else noticed heat as a side effect of a particularly bad bruise

b) I've noticed (or think I've noticed) that Dougie's scars and scabs since he had ITP are different from before - scabs are smoother and scars seem to be more noticeable. He seems to me to take longer to heal than my other kids do. Maybe its just my imagination????

Ali

P.s - I am not sure they know what bug caused the problem. They said that infection was indicated because his neutrophils were very high and lymphocytes were low, and they treated him on the basis that he had cellulitis.

Maybe I'm wrong, but I've read that a lot of ITP patients have high lymphocytes and low neutrophils. Caitlin always has this but I thought this was just a "breakdown" of the wbc which is always low for her too. It doesn't matter what Caitlin's wbc/lymphocyte/neutrophil count is...she always feels the same and doesn't get sicker than the average teen. (However, lately we have noticed her getting sick about every 2 weeks but her counts don't seem to reflect any changes.)

My co-worker had cellulitis and they treated it the same as MRSA. She had to have a port put into her chest so that medication could go directly to wherever it needed to go. She had it on her calf. I think she had to wear this for like a month. (Said it was the most painful thing she had to go through, but as a single mom, she could not take off work so she just worked through the pain.)

I thought that autoimmune conditions often went with low lymphocytes. I've always had low lymphs, even long before ITP appeared. Neutrophils aren't usually low in ITP unless there's also an immune neutropenia present.. or so I thought.

Pauline, Dougie had 3 1/2 days of IV antibiotics through a canula in his hand and a further two weeks of oral antibiotics. It seems to be doing the trick. It was VERY painful for him - the 14 days of christmas holidays have been a bit of a wash out for him really because the first day he couldn't walk properly, next four he was in hospital, next six he had to keep his leg elevated. He's been saying that he needs to get some exercise in now because he feels so unfit!

Dougie has never had any blood results out of range before other than those to do with platelets, so they were pretty sure it was infection. My other son though has had a number of blood tests and his are always all over the place; I think they've just concluded thats normal for him, and he's a very normal healthy teenager.

Ali