Saturday, February 1, 2014


{Exposition: Late last week we received an e-mail that a couple of children in C's daycare had developed hand, foot, and mouth disease}. On Saturday we joined the Y in an effort to turn over a smaller, more fit leaf - it's a nice gym and has a very spacious and well-staffed childcare area.  We filled out the forms, paid the money, signed C into the child area, and 'worked out' which consisted of us walking on the treadmill listening to NPR podcasts. Baby steps... actually, just very slow adult steps. We retrieved C and as we were buckling her into her carseat Luke noticed little bumps on her ankles. Hmmm... probably just irritation from her mary janes, I thought.
However, as the day progressed, a rash also erupted on her hands, as well as worsening on her feet.  Rash on hands and feet... must be hand, foot, and mouth, right?

But by Sunday the rash was much angrier and worse looking... and did not look like the rash of HFM that preferentially shows up on the palms/soles. Her eruption was the opposite - everything on the dorsal surface and nothing on the palms and soles. After texting this photo to my dermatologist friend (a special shout-out to my dermies who do not seem to mind the startling and gross pics I send them occasionally- thank you!) and my dad, my dad said - you should take her to be evaluated. That looks bad. - It did look bad and because it was Sunday we had no choice but to take her to the emergency room ➴

Where as we waited (not too long) and were evaluated, the rash worsened in front of us. She was also drooling like crazy. The ER docs thought it wasn't typical for HFM, called peds, who thought it looked like bad HFM. Because she was perfectly fine otherwise - in a good mood, no fever, eating well, ins/outs normal - we were sent home with a follow-up appointment in the pediatric clinic the next day.  On Monday the pediatricians agreed it looked atypical (voicing aloud the second central tenet of medicine - You are interesting my dear and you never want to be an interesting case!) and off we went to dermatology later in the day. Luckily, the dermatologists took one look at her and in conjunction with the compelling recent exposure history and visualizing the little sores in her mouth, she was pronounced to have an atypical strain of HFM that they have seen several cases of recently, a rash that presents in a very dramatic fashion. And, just as they predicted, she produced no new blisters and has been improving every since.

Wednesday. Maybe not the happiest day.

And today even better.  Her hands are peeling and she is using her little pincer grasp to peel off slivers of dead skin and hand them to us... oh, why thank you, Clementine. I called the Y when her diagnosis was confirmed to tell them that our first act as Y members was to spread virulent contagion (when we signed her out she was chewing on a Lincoln log - bringing to mind one of my favorite words, fomites)-- sorry about that, YMCA... Luckily she was not ill throughout the episode and though Luke is exhausted from a week home with her (she is everywhere and into everything), we all emerged unscathed.  After this and his violent GI bug, Luke was bracing himself for what terrible sickness this weekend would bring... so far, so good :)
Though we are out of the woods and can joke a bit about it now, it was quite upsetting to see the perplexed doctors and hear them raising very serious differential diagnoses. Again, fortunately, her hand/foot/mouth rash turned out to be just that and we loved on her extra hard this week. 
[TMI?  Perhaps someday I will have to issue a mommy blogger's lament]

1 comment:

  1. I was a child who was quite an interesting case to many docs at Queeny Tower in the 70's. Imagine being rubbed down with tar and wrapped in Saran Wrap to sleep as an experimental psoriasis treatment!