Bactrim, Yeast and a Rash, Oh My

Chemo round #2 is officially on temporary hold. We got up, went to the clinic and were all set and ready to spend the day in the clinic or the OMO to get fluids and the next cocktail of chemo. Close, but no cigar.

Turns out we have thrush and a rash.

Thrush is an overgrowth of a yeast microbe, candida, in the mouth. Her tongue is white. Its actually pretty gross.

Thrush is not a surprise in a patient receiving chemo. At one point her neutrophils were at 0, and she was taking oral antibiotics. A recipe for thrush, really. Unchecked by other normal flora (killed off by the antibiotics) and her normal immune response (white cells) you probably could predict it.

So, thrush is really no big deal. Not sure if they would have given the chemo with the thrush, but its possible they would have. The worrisome thing is the rash.

She has a rash that started yesterday on her legs, then spread to her arms and finally, today, her face and chest. The big concern of the doctor and nurse practitioner in the clinic was the possibility that the thrush was spreading via her bloodstream, causing the rash.

So, what to do? Oh, wait - there's a children's hospital right across the street! Yep - we were admitted.

So far, things have gone ok. At first she was in "isolation" - not knowing what is causing the rash, the nurses were wearing gowns, gloves and masks anytime they touched or interacted with her.

So, what's causing the rash? Could be several things. Could be a systemic infection. Could be a contact dermatitis. Could be a reaction to a medication. Just not sure yet.

But, since she's not running a fever, we believe they've ruled out the systemic infection. That's a great thing. That would have meant a prolonged admission.

Best guess right now is that it is a reaction to the Bactrim she's been on. They've given it to her three days a week (Monday, Tuesday and Wednesday) to help prevent pneumocystis infection in the lungs. She's had so few antibiotics in her life (so healthy before all this) it's certainly possible she had a delayed reaction to the sulfa in the Bactrim. That will make 2 allergies on her profile now. She had a rash after morphine as well.

If things go well (though our history doesn't give me a lot of confidence they will) we may be able to go home late today or tomorrow. At least that's what we've been led to believe is possible. That would be nice, since tomorrow is Harper's 8th birthday.

Until we learn more, we sit here. Where is that yellow brick road, Toto? There's no place like home.