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Rash with swelling, hardened lumps and joint pain
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Rash with swelling, hardened lumps and joint pain

My 6yr old has developed a rash on her outer extremities sparring the trunk with pain for 3-4 wks.
The rash developed April 17th, red speckled spots on legs within two days had inflamed like chicken pox. I took her to her paediatric that Monday who diagnosed her with scabies by just looking at her. We did the permetherin (sp?) cream treatment twice in a matter of 7 days - per doc's orders. I took her for a check up the following Monday and doctor said "not scabies take her to children's emergency hospital". We went to children's hospital that same Monday morning and after blood work and urine work everything came back normal except she was anemic - no surprise since she has sickle cell trait. More doctors came to look at her and we left the hospital with the diagnosis of Gianotti Crosti Syndrome. Take benadryl for the itch and calamine lotion as well. She can go to school - no problem per doctors orders.
Two days later - Wednesday (5-1) my daughter Deleilah was sent home from school. She had vomited and was complaining of stomach pain.  I left work early to rush her back to the hospital. While we were there Deleilah needed to use the washroom. Her stool was bloody so I notified the nurse. They did more blood work, urine test and now required stool test. Stool test came back positive for bacteria called C. Difficile. She was admitted for two days. While we were there her rash was itchy and inflamed - nurse gave her benadryl. She walked in the er with pain on the backs of her knees which prevented her from straightening her legs very difficult to walk. Pain went away in less than 24 hrs. The doctor prescribed flagyl every six hrs for ten days - no school until further notice.
She was released on Friday (5-3). Later that night her right foot was swollen she couldn't move her toes. It was extremely painful for her. She couldn't put any weight on her right foot and she wouldn't let me touch her foot. Pain reliever was given - she fell right sleep.
-- rash around foot was noticeably inflamed more so than the rest of her body - due to swelling?
The following morning swelling had gone down but now foot was purple and tender to touch.
Monday (5-6) At night I noticed the rash was starting to get inflamed - she started complaining about her left wrist. Left wrist was swollen and spread to her pinky and her thumb - she couldn't move them! Again she was in pain. I checked the rest of her body and her right ankle looked like it was protruding. She had a hardened lump on top of her ankle - painful to the touch. I gave her pain reliever she went to bed. The next morning the swelling was gone but her wrist was bruised. The lump on her ankle was gone. I contacted her doctor who set up an appointment for Deleilah with a dermatologist for Thursday (5-9)
Wednesday (5-8) she woke up with two lumps on her head. One was right on top of her head the other was behind her right ear. Hot to the touch - also very painful. She felt like something was pulling her hair.
Thursday (5-9) At the dermatologist a lump appeared on the top of her left hand. She was complaining she couldn't straighten her left arm. By the time we left her elbow was twice the size. The doctor did a skin biopsy and I won't have results for 5 days. He recommended I see a rheumatologist for her. He seems to think it might be due to the sickle cell trait.
Friday (5-10) by night time she was unable to walk. She complained her foot hurt. The bottom of her left foot was swollen.
This whole time she has had a temp of 99.5. The swelling and the pain is gone in 24 hrs comes back every 72 hrs. The hardened lumps show up every other day and are gone in less than 24 hrs. She says her pain feels like her bones are breaking. The rash has worsened - bright red and lumpy. She cannot do simple tasks anymore - can't open a water bottle, walking up the stairs is difficult, not able to bend legs all the way.
I need help!! I won't be able to see a rheumatologist until June 27 - if her doctor can't convince him to give us an earlier appointment.

Her doctor has no idea what this is, everyone is extremely concerned. She has not been able to go to school. Deleilah has always been healthy but since starting school last fall has been diagnosed with coxsackie virus, strep throat and a bladder infection.

Any ideas??
6 Comments
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4851940_tn?1385441629
So sorry to hear that your daughter is so poorly.

Is it possible that she has contracted the coxsackie virus again and this has now worsened affecting other parts of her body?

With her being anaemic and having a sickle cell trait her immune system is weakened.

Keep her comfortable with plenty of fruit juice drinks and whatever has an appetite for.

Make sure that everything is clean and her toys washed.  Infection usually is spread by fecal-oral contamination, although occasionally the virus is spread by droplets expelled by infected individuals. Items like utensils, diaper-changing tables, and toys that come in contact with body fluids that contain the virus may also transmit them to other individuals.

Hopefully you will get a diagnosis soon so that your daughter can be treated appropriately.

I presume as she was prescribed with Flagyl that there is no protazoal infection now.

As bacterial and viral infections have been ruled out, has she been checked out for any parasitic infestation?

Her body is fighting something.

Wishing her a speedy recovery.

Best wishes.
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Sickle cell usually affects the spleen.  has the doctor checked her for inflammation of the spleen?  The blood cannot filter properly through the spleen because of its sickle shape.  She needs to see an Internist asap.  Many sickle cell patients do much better after the spleen is surgically removed.  - Meanwhile, yams and tapioca will help her feel better.  Why?  Because these are staple foods in Africa where there is very little Sickle cell anemia. -  I sincerely hope you find some help for your little girl soon.  It's so hard to watch a child suffer....
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This might sound odd, but have they tested her for Lymmes disease? That can cause terrible rashes, swollen joints and arthritis type symptoms. My daughter went to school with a girl that had it, and it nearly crippled her before they diagnosed what she had.  Just a thought.
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Avatar_f_tn
This might sound odd, but have they tested her for Lymmes disease? That can cause terrible rashes, swollen joints and arthritis type symptoms. My daughter went to school with a girl that had it, and it nearly crippled her before they diagnosed what she had.  Just a thought.
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5457294_tn?1368274510
Thanks for the posts. We have had more blood work done for rheumatoid arthritis and lupus and are now waiting for results. The doctor has ruled out diabetes, allergies, and sickle cell trait effects. She also says her spleen is very good as well as her liver. Now we wait.
The rash is still there it has travelled to her back and some on her stomach. Dad and I have noticed that any type of stress makes the rash appear red and inflamed and this is followed by the pain and swelling. She's a trooper and she's dealing with whatever this is very good.
Thanks for the input and concern. I will keep you updated.
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4851940_tn?1385441629
Hope they find the problem soon so that she can be treated appropriately and on the road to recovery.

Best wishes.
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