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» LymeNet Flash » Questions and Discussion » Medical Questions » Rocky Mountain Spoted Fever Rashes?

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Author Topic: Rocky Mountain Spoted Fever Rashes?
wtl
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My 4 year old has been taking cefdinir for about 2 months now and I have been happy to see she stopped complaining about her leg pain. I was hoping that if this continues, she could be out of abx in another 3 wks or so.

And then over the weekend, she started to develop rashes that look like from poison ivy - little red blistery spots on her hands and feet but nowhere else. I think they are slightly itchy.

I was searching for some photos and they look like this one on LDA site:

http://www.lymediseaseassociation.org/PhotoAlbum_RashOther.html

Is this possible, after two months of treatment?

I am just crashed...

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wtl
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Ops, the link did not send me to the right photo. It is the last photo on this batch that I was refering to.
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Pinelady
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Yes. It took me 3 mths to get my rash.

And I still have it. And I'm still treating.

Lots of us have crazy rashes that come and go.

There was a new species identified in CA by UOfChicago I believe last year. It was described as a spotless variety....Just a thought.

Be sure and get lots of pics. And a timeline of presentation to fading etc. might come in handy.

--------------------
Suspected Lyme 07 Test neg One band migrating in IgG region
unable to identify.Igenex Jan.09IFA titer 1:40 IND
IgM neg pos
31 +++ 34 IND 39 IND 41 IND 83-93 +
DX:Neuroborreliosis

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wtl
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What if this is "hand, foot, and mouth disease"? Do the rashes look similar? I can't tell from the small picture.

She did have a high fever two days earlier, but the fever went away after a night sleep. I am taking her to see her family doctor here. She is not particularly lyme literate though but seems to be gentle enough to not making too much comments the last time I was talking to her.

We will see.

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nenet
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Wow, I am so glad to hear about your daughter's leg pain improving, wtl! That is wonderful news.

That sounds very much like a RMSF rash to me. That is the most common RMSF rash - hands and feet only. Here is a link directly to the photo you mentioned:

http://www.lymediseaseassociation.org/_images/Photo_Rash_TBD_005.jpg


Hopefully her PCP Dr can test her for the Hand Foot and Mouth Disease virus and rule that out.


TBD rashes can definitely show up much later during treatment. I got about 6 different EM rashes about 7 months ago, after over a year of treatment. They still haven't gone away.

I would run this by your LLMD as well. You can call them and email them photos of her rashes.

I hope you have already taken good pictures of her rashes, so that you have documentation, and something to show when/if the rash goes away.

Can you take a pic of just her hands and/or feet and post it here? That might help others compare.

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sammy
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wtl, I was just thinking that. This is the right time of the year for "hand, foot and mouth disease". Those are classic symptoms.

Hope she feels better soon!

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wtl
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nenet - Wow...What a surprise to hear from you. It has been a long time. My wife and I talked about you often and wish that you are still close to chat with.

And thank you for the link to the photo. That was what I was thinking. Here is a picture I took of her hand but I am not sure how well one can see the rashes I was talking about.

Not familiar with RMSF. Is that Lyme related, nenet?

sammy - thank you for the thought. I am hoping that's what it is, though I have no idea what i was wishing for. Seems that anything other than Lyme related is a good news to me. Can one have this disease more than once in their life time? I thought she had that about two years ago.  -

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wtl
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Wait, where did the photo go?  -
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wtl
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I gave up. I don't know how to attach a photo, I guess. Sorry.
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tick battler
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You can definitely do a blood test to see if her titers are high for hand, foot and mouth disease.
My kids had it last winter.

I hope that's what it is!
tickbattler

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TF
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Click on the pictures at this link, and the pictures will get very large.

Then, you can see what hand, foot, and mouth disease looks like on the hand and on the foot.

http://www.mayoclinic.com/health/hand-foot-and-mouth-disease/DS00599/DSECTION=symptoms

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nenet
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Hey wtl, it's good to talk to you too. I've thought about you guys a lot, and hoped you were well, or getting there. I just haven't been active around here or on chat in many months, due to a lot of things going on.

RMSF is Rocky Mountain Spotted Fever. It is usually abbreviated in most references. It is a fairly common tick-borne infection, and happens to occur pretty much all over, even a lot in the south.

Its name is very misleading - it only was named that because the pathogen was discovered in a lab based in the area of the Rocky Mountains, though the ticks that hosted the disease were from elsewhere.


She should definitely be tested for the HFMD (Hand Foot Mouth Disease) virus by her regular doctor, but her LLMD really needs to see the pics right away and know what's up because if it is RMSF, she needs to have her treatment evaluated to make sure it covers RMSF. It is a very dangerous disease. It can cause a fever, as can herxing, which she might be doing as well.


To Post a Picture:

You can post the picture by going to image shack ( www.imageshack.us ) and uploading the photo there. Then they will give you a link to the photo that you can post here.

For anyone curious, lymenet can't host photos - that takes up a lot of space on the server and would be very expensive. You have to put a photo on a server that is on the internet and will host public files, like image shack, or tinypic, or other image hosting websites.

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Lymenet Success Stories

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nenet
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This site has good pictures of some RMSF rashes:

http://dermatology.about.com/cs/infectionbacteria/a/rmsf.htm

scroll down to the links to pics of rashes on hands, feet, face, and arms.


One source on HFMD seems to say that the HFMD rash appears only on the bottom of the feet, not the top. I'm not sure if that's true but it's something to look into.

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wtl
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Ok, let me try to see if the photo loads... RMSF?
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nenet
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It worked!

Do you have pics of the rashes on her feet?

Are they on the tops of her feet or the soles?

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wtl
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It works. Thanks, nenet. Please come more often as I do miss you around. I will send a photo to her llmd so that he can see what he sees.

I hope "much going on" only relates to relocation and not Lyme gets worse. PM or email me if you want to update me. I care.

TF - Thanks. I looked at those photos and the spots on the foot look a lot like hers, but the one for the hand is a bit different. It seems that the blisters on the photo is more pronounced than what she has. I hope her doctor will be able to tell for sure.

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wtl
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Here is a photo on her feet. Foot
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Carol in PA
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Here are your photos.

 -

 -

The photos for the Hand-foot-and-mouth Disease state that:

Hand-foot-and-mouth disease often causes a rash of painful, red, blister-like lesions on the soles of the feet....and on the palms of the hands.

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wtl
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Carol - you are the magician.
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wtl
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So her PCP thinks it is the hand, foot and mouth virus and she is conscious enough to not prescribe her the steroid cream. I will keep an eye on her for the next few days.

Thanks for all your thoughts.

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Pinelady
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That looks like my daughters rash after she had her MMR. Measles like was what they called it...

--------------------
Suspected Lyme 07 Test neg One band migrating in IgG region
unable to identify.Igenex Jan.09IFA titer 1:40 IND
IgM neg pos
31 +++ 34 IND 39 IND 41 IND 83-93 +
DX:Neuroborreliosis

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wtl
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Is MMR different than hand foot and mouth, Pinelady? Any need for treatment?
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Tincup
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Ehrlichiosis and Rocky Mountain Spotted Fever can both cause rashes like in the photo you shared.

Untreated, they can both become chronic infections with hard core late stage symptoms.

Remember the photos in the medical literature are often taken of some of the worst cases ... not the more typical or common forms.

Just so you know to keep watching.

Hope your little one is doing better soon.

[Big Grin]

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wtl
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Oh boy...

How long do the rashes from SRMF or Ehrlichiosis typically last? I have sent these photos to her doctor but I haven't heard back from him.

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nenet
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wtl, I don't understand your Doctor.

Hand Mouth and Foot Virus causes rash on the palm of the hand, and sole of the foot.

That is not the rash that your daughter has in these pictures - hers are on the top!

Did her doctor actually test her for the virus??

I am leaning even closer to co-infection(s) - in my non-medical but very worried opinion, you need to call her LLMD and be persistent with them, as this can be extremely serious.

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wtl
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Thank you, nenet. She didn't test for anything.

I will call her llmd tomorrow so that hopefully he has the time to see the pictures I sent today. This now really worries me.

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sammy
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Medline plus gives a good explanation of symptoms, diagnosis, and treatment of hand, foot, and mouth disease. They also have pictures on the Right hand side of the page. One picture shows the blister rash on the top of the foot. The rash can be inside the mouth, in the genital area, on top of the hands, palms of the hands, lower legs, tops and soles of feet. It is not limited to only palms and soles!

Here's the link to medline: http://www.nlm.nih.gov/medlineplus/ency/article/000965.htm

Medicinenet is another resource with pictures. Click through the information on page 1 and 2, on the 3rd page are some links to pictures. http://www.medicinenet.com/hand-foot-and-mouth_syndrome/article.htm

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wtl
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sammy - thank you for the further research on my behalf. This gives me some comfort.

The only thing I don't see from my daughter's hands and feet are those bigger blisters that seem to "pop open". She just have a bunch of small red spots that are slightly raised, like what's shown on the photos.

Her mouth is all clear, and she doesn't have sore throat.

I am hoping it's just HFMD.

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Pinelady
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WTL is was from her Measles/Mumps/Rubella.
It was the last one for us.
She went on to inability to walk with extreme low white count.
-------------------------------------
I should add she went on to be very healthy after that---until we found the ticks.

[ 06-09-2010, 12:01 AM: Message edited by: Pinelady ]

--------------------
Suspected Lyme 07 Test neg One band migrating in IgG region
unable to identify.Igenex Jan.09IFA titer 1:40 IND
IgM neg pos
31 +++ 34 IND 39 IND 41 IND 83-93 +
DX:Neuroborreliosis

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sammy
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wtl, with HFMD the red spots may not all turn to blisters and the blisters may not pop open. And she doesn't have to have a sore throat. If she's had it before, her body might be more equipped to handle the infection so her symptoms may not be so severe.

If you will, let us know what her doctor says when he sees the pictures and or examines your daughter.

There are so many things that can cause rashes or small red raised bumps (infections, contact dermatitis, mites, etc...) That's why it's important to have someone experienced to take a look at the whole picture: clinical exam, signs and symptoms, tests if necessary.

Try not to worry.

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wtl
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Thank you again.

I am still waiting for her llmd to call back. It won't be the physical examination by the llmd regardless because he is 10 hours away, but i was hoping that he could look at the pictures and give some ideas on what needs to be addressed.

I did, however, call back her family doctor's office and insisted that she offers more than she did yesterday. What she could do is to run a simple test to separate virus from bacteria so that she could decide if any anti-biotic is needed. She said she won't be able to "identify" what virus (or bacteria for that matter) without running some expensive tests and she can't see the needs for it at the moment.

I told her that, if that's the case, we will just wait for a few days and see what happens. I didn't want to tell her that she is already on antibiotic for her Lyme.

One bit that did p*ss me off is that she had conceded to say that her diagnosis is based on seeing the rash on her hands, but she didn't take a look at her feet. She said she just took my words for it. What the h*ck. I wish she would take my word for Lyme, instead of the rash.

So hard to find a competent and caring doctor, I tell you.

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wtl
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Further update:

So her llmd called back and said that actually for once he agrees with her family doctor in this case. He asked to stop the antibiotic all together for her until the system clears. He explains that we shouldn't confuse the antibiotic tot he immune system because they are not interchangeable. In this case, she should be off the antibiotic so that her immune system can kick in and take care of the virus. Otherwise, her system would continue to confuse.

It seems to make sense. I would just follow the instruction and hopefully everything is going to be okay.

I am more than grateful to all of you for your generous help.

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gatorade girl
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Up. Wtl. What ended up happening my daughter has blisters and red rashes on her hands and feet.

--------------------
gatorade girl

"I still have Mt.Everest to climb, but I have traveled across the world and arrived at the mountain".

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