[sheller617]

My 16-month-old daughter has recently gotten over the Strep virus, which was treated with antibiotics, and a yeast infection, which was treated with a cream. She has been off both medications for about two weeks. For the last three days, she has been fussy, had diarrhea, and has been drinking liquids more often. Today, I found a hard, bite-like bump on her behind, right by the crack. It looks a little like a bite, and it feels warm. When I touched it, she started to cry, so I know that it is hurting her. She has not been feverish, but she has been acting as if she is in pain. Should I take her to the ER or call her doctor? I'm afraid that it could be MRSA...

[Wondergirl]

It could be the beginnings of cellulitis. I'd get her into the doctor asap. If that would more than a day or two from now, then go to the ER. Our site nurse may be on later and will give you more precise information about what to do.

[sheller617]

Thank you... it has me very worried because she is favoring the left side of her bottom when she sits, and the bump is on the right side... I really just want to know if I should take her in to the ER tonight or wait until tomorrow to call her pediatrician...

[Wondergirl]

Thank you... it has me very worried because she is favoring the left side of her bottom when she sits, and the bump is on the right side... I really just want to know if I should take her in to the ER tonight or wait until tomorrow to call her pediatrician...

I PMed J_9, our site nurse, so hopefully she will be online before too long. She works nights and might be sleeping right now.

With a baby that young who seems to be in pain, I would go to the ER. I've had cellulitis, and know it spreads like wildfire. I was in the hospital with it for two weeks before they got it under control. They did cultures and guessed it was a staph infection, but never really found out (the cultures were too sterile from all the meds they were pumping into me).

[Alty]

From what you describe it could be MRSA, but it could be any number of other things. There's really no way for anyone online to give you even a guess at a diagnosis.

Here some info on how to diagnose MRSA:

Diagnostic microbiology laboratories and reference laboratories are key for identifying outbreaks of MRSA. New rapid techniques for the identification and characterization of MRSA have been developed. This notwithstanding, the bacterium generally must be cultured via blood, urine, sputum, or other body fluid cultures, and cultured in the lab in sufficient quantities to perform these confirmatory tests first. Consequently, there is no quick and easy method to diagnose a MRSA infection. Therefore, initial treatment is often based upon 'strong suspicion' by the treating physician, since any delay in treating this type of infection can have fatal consequences. These techniques include quantitative PCR and are increasingly being employed in clinical laboratories for the rapid detection and identification of MRSA strains.[24][25]

Another common laboratory test is a rapid latex agglutination test that detects the PBP2a protein. PBP2a is a variant penicillin-binding protein that imparts the ability of S. aureus to be resistant to oxacillin.[26]

http://www.google.ca/url?sa=t&rct=j&...,d.cGE&cad=rja

This is going to end up as a judgement call. You have to determine how worried you are. Do you think it can wait until tomorrow? If not, go to the ER.

I can only tell you what I would do, and base my decision on my doctors care, versus a hospital. My doctor cannot perform the tests necessary to determine what's going on. So, I could see him tomorrow, he'd request lab work, I'd have to go to the lab to get that work done, and even if it's STAT, I wouldn't get results until the following day. At the hospital they can do the lab work right there, and I would get results within a few hours.

But that's where I live. That's also what I would do in your situation. This is really your call, your decision.

[sheller617]

Thanks for the help... I feel like I should take her in to the ER, so we are headed there now... I will post back once I know for sure...

[Wondergirl]

Thanks for the help... I feel like I should take her in to the ER, so we are headed there now... I will post back once I know for sure...

Yes, please let us know!

[Alty]

Thanks for the help... I feel like I should take her in to the ER, so we are headed there now... I will post back once I know for sure...

That's what I would do.

Please, do keep us posted, and I wish you the best of luck. Hugs for the little one, and a speedy recovery.

[J_9]

It could be MRSA, or it couldn't be. There is no way for us to know without examining or culturing the wound.

Most likely it isn't, as MRSA is typically acquired via transmission from an infected person to a non-infected person. If she is in daycare, it is a possibility.

I don't see the need for the ER tonight, but you could sit her in a warm bath to help bring the boil to the surface so as to burst on it's own. MRSA has a terrible foul smelling odor.

Call the pediatrician first thing in the morning. Most likely it is a blister formed by the soft moist tissue caused by the diarrhea.

[sheller617]

Thanks for all of your help, everyone... we went to the ER that night, but ended up leaving after we waited for almost 3 hours without a doctor checking her. I got her into her pediatrician yesterday afternoon, and she diagnosed it as cellulitis. She has already started the 10-day antibiotics, so please keep your fingers crossed that it will work :)

[Wondergirl]

Thanks for all of your help, everyone... we went to the ER that night, but ended up leaving after we waited for almost 3 hours without a doctor checking her. I got her into her pediatrician yesterday afternoon, and she diagnosed it as cellulitis. She has already started the 10-day antibiotics, so please keep your fingers crossed that it will work :)

Thanks for reporting back. I've done the cellulitis dance more than once, so my healing thoughts go out to her.