Some of you with a lot of sinus infections in the family wanted more information about how a sinus infection ended up in a Tuesday-Saturday hospitalization, and that is something I am not sure I can answer well: we DON’T get a lot of sinus infections at our house, which makes it hard to compare a typical one to this one. I got a sinus infection a number of years ago, and when my teeth started hurting I went to the doctor, and she gave me an antibiotic and I took it, and the sinus infection went away, the end. So that’s not super helpful. But I can tell you some of the miscellaneous things doctors mentioned as if they were important, and maybe those will make more sense to those of you with more experience.
One key element in Edward’s case is his Crohn’s disease and the immunosuppressant medication he takes to manage it (Remicade). One of the doctors said that this can make him vulnerable to some of the weirder little bugs that the rest of us would fight off easily.
This might be why the first antibiotic didn’t work: the pediatrician was assuming it was a sinus infection from one of the usual culprits, but maybe it was a weird culprit. Many doctors asked about MRSA and other antibiotic-resistant infections, and whether anyone else in the family had dealt with one. (No.)
Is it helpful to know that the ER doctor said the CAT scan showed allllll of the sinuses were infected? I didn’t know there WERE “allllll”; if asked, I would have thought there was one sinus that stretched across the face, or maybe two sinuses, one on each side—something like that. But there are sinuses up all the way around the cheek/eye region, and all of them were involved. I don’t know whether that’s typical.
The ER doctor mentioned that one sinus region (he pointed near his own eyebrow) has a membrane divider, and that there was so much infection in there, the membrane was “bulging,” and there was concern about rupturing. That’s just so gross.
An ENT doctor said that all the little passages up there were very small (that is, Edward’s set of passages were unusually small), and very swollen, so the sinuses couldn’t drain.
There was a lot of concern about the possibility of an abscess—a walled-off area of infection. If I’m understanding everything correctly, they did find one or two of these.
There was a lot of concern about his eye possibly being infected. The area around one eye was swollen and a light reddish-purplish color. (At one point it was swollen almost shut: that was after we arrived at the children’s hospital but before surgery.) Apparently it is not unusual for sinus infections to cause a little puffiness, but this must have been more than typical, because everyone involved was very interested, and we had an ophthalmologist in our room at 8:30 at night; she brought a suitcase of equipment. If there HAD been eye involvement, he would have needed immediate surgery that very night. Two doctors (the ophthalmologist and an ENT doctor) had a rather heated discussion about it right there in the room, when she (the ophthalmologist) had determined there was no eye involvement, and he (the ENT doctor) questioned her judgement and wanted to do another CAT scan “just in case.”
Something they found during surgery was that the flesh of his cheek was disintegrating. I will tell you that freaked me right out. The surgeon acted like that was a normal thing to say. I asked if my child’s face was going to continue to disintegrate and he acted as if that was a funny question to ask, but SERIOUSLY IS HIS FACE GOING TO CONTINUE TO DISINTEGRATE, I DIDN’T REALIZE IT COULD START TO DISINTEGRATE.
Cheek disintegration suggested to the doctors that this could be a fungal infection rather than a bacterial one; fungal infections are apparently another thing that can happen with immunosuppressing medication. They cultured everything, but didn’t get any decisive answers: one doctor mentioned they’d found some bacteria, but later more than one doctor mentioned finding no bacteria and no fungus. At first I thought that was a good thing (LESS bacteria/fungus in my child’s face) but it’s not exactly good: if they don’t find what it is, they don’t KNOW what it is, and that can make it harder to treat.
One of Paul’s co-workers gets a lot of sinus infections, and she was interested in the antibiotics, so I’ll put that here. The first doctor gave him cefuroxime, also called Ceftin; that’s the one that didn’t work. I don’t know what exactly he got by IV: he got a dose of something in the ER, and then they put him on two different IV antibiotics in the hospital; after a day or two, they took him off the one that was for antibiotic-resistant bacteria, because they felt that was not as likely to be the situation. They sent him home with cefpodoxime, which they said was fairly equivalent to the other of the IV antibiotics.
If you have any questions, like about things that I might not have thought to compare to regular sinus infections, I can attempt to answer those too.
How terrifying! I am holding you all close.
Oh my goodness, Swistle, what an ordeal. I knew sinus infections could be serious, but I had no idea that they could be so…complicated? That’s not the right word. I’m struggling for words because, like you, I’m hung up on the cheek disintegrating. I’m assuming now that he’s out of the hospital that he is in the clear? I hope? I am sending lots of virtual hugs and also virtual wine because I feel like I need a glass just reading this, cannot imagine how you must be feeling. I had a sinus infection once that required antibiotics, but it was the same as you – sore teeth, and then the antibiotics made it better, and I had a nap. The end.
Good lord! This seems like an all around awful experience! I hope he is all better now.
Good GRAVY. Thank you for elaborating, Swistle. I had been curious about it myself–I had a sinus infection all the time during the year and a half I taught pre-K, and my poor mom gets them routinely. But neither of us has EVER had anything that scary.
Wow that sounds so stressful! Poor Edward. I hope he is feeling better.
Yikes. I have no experience with this, so glad he is doing better. One possible planning-ahead health-related thought — I live in the US southeast, have all my life, and like many people here live in a home that was built many decades ago over a dirt crawlspace. And when I say “dirt,” I mean “clay.”
Our home has long had a mustiness problem, and the past few years having had unusually high rainfall has definitely not improved matters. Last year we decided to get our crawlspace sealed and a dehumidifier installed down there and it has made SUCH a difference. This is just from the perspective of “human nose detection of musty air,” no science involved (well, I can tell you that the crawlspace itself is much less humid than it was, because we do have actual data on that). But one of our dogs who had a chronic low-grade cough, the cough is … gone, and my niece who has asthma did not have attacks (which she often has in the past, and not just here, so perhaps she’s aging our or learning to manage it better or who knows) when she visited this summer.
All of which is a long way to say that particularly given that you have I think bought an older house, it may be worth having this type of issue examined and addressed, given the immuno-suppressants? Though I know nothing about where you live and have a vague sense it is farther north and colder and perhaps drier than where I am, so maybe this is in no way relevant. But just in case.
And again, key point, so glad he is doing better. Yikes!
Poor Edward, Poor Swistle! That sounds just awful. I hope he’s feeling better.
Oh gosh what a scary situation for you all!
One of my closest friends has ulcerative colitis, which is not dissimilar to Crohn’s – and a few years ago when I was unfortunately living 5000 miles away, he had an ingrown hair on the back of his hand – which turned into 3 months in hospital, several surgeries, nearly the loss of several fingers and new skin having to be grown by attaching his hand to his stomach for a while. Those immune suppressing drugs are no joke! The good news is that he’s totally fine now, he just has a very scarred hand. But your situation with Edward really reminded me of that time and how anxious I’d be for updates because his body just didn’t seem to react to things in the same way as other people’s. So glad Edward is doing better now.
I am SO glad you updated. I was wondering if it was Crohn’s-related, and sending you all the positive energy I could (I am a prayer person but I know you are not so I didn’t want to be disrespectful.) That’s a horribly frightening experience.
How is Edward now? Will he be back to school on time? Is he in pain? Do take care of yourself and your own stress levels. Much love to you, Swistle, I care about you and your family very much.
Well, that sounds very scary. I had a similar situation develop many years ago, not from a sinus infection, but from a wisdom tooth extraction (turns out one of the extracted teeth was infected). Regular antibiotic didn’t work, then IV antibiotics didn’t work, then I developed an abscess and had to have surgery. One thing I remember the ENT saying is that facial/head/neck-area infections can spread very, very quickly, and also they can be extra dangerous because of the proximity to the brain.
So, moral of the story is to not ignore it, and wait until your ENTIRE FACE IS SWOLLEN and you can no longer open your MOUTH, as I did (I ended up in an ambulance). (I haven’t had any issues since then).
Glad Edward is ok-how did he handle it? FTLOG, he didn’t hear the cheek-disintegration thing, DID HE??
Yikes! All those things (DISINTEGRATING cheek? abscesses? [how is this the way “abscess” is spelled?] swollen eyes?) — and I am picturing them discussed casually and neutrally in The Way of Doctors — sound terrifying and like they require LOTS of follow up questions and/or deep context. I hope Edward is feeling better and that you have LOTS of medicinal chocolate at home for you both.
How interesting and scary. Thank you for sharing. Sending positive thoughts your way. Hope Edward is feeling much better.
When my son was younger he got a big bite that swelled so big his eye was swollen shut. The dr put him on an antibiotic because he said something about there being a direct passage up the forehead to the brain and if it got infected that would be bad. I wonder if Edward’s doctors were concerned about that as well.
I am so sorry this happened! Sick kiddos is so stressful! Glad he is on the mend.
That’s so scary!! Glad you are all back home. I’ve had ongoing sinus issues for years and I was told I would need surgery at some point so I’m interested in what the recovery period has been like. I too have small sinuses that get blocked and infected easily. It’s never gotten as bad as what you described but I get radiating pain down my neck a few times a year. A doctor once told me that one reason we have sinuses is because our heads would be too heavy for our necks without some empty cavities.
Oh my God! I’ve had sinus infections and they were never a big deal; no fun but not a big deal. In fact, I had no idea a sinus infection COULD become such a big deal. I’m glad he’s home and everything is back to normal (it IS back to normal, isn’t it?).
That sounds horrifying and scary, poor Edward (and poor Swistle). And that whole “we think it might be that but oh, it’s not, and now we’re all out of ideas” is just not reassuring at all.
I hope he feels tons better now.
Are you allowed to give him probiotics to help his gut health after the antibiotics? When I have to take any, which I try to avoid but I had some horrible tonsil/throat infections where it couldn’t be avoided, I’ve started to take pro-biotics to help repopulate my digestive system with good bacteria and avoid antibiosis. Mine are from the pharmacy and come as a powder that you mix with water and then drink at least 15 minutes before eating the first meal of the day. It’s a mix of 15 “good” bacteria cultures, and it’s supposed to be done already during the antibiotic treatment to support the digestive system (even when during that time, they keep getting killed off again by the antibiotics – it’s still helpful), and then for at least two weeks after.
I’d expect that with Crohn’s, supporting the digestive system would be even more important on the one hand, but maybe also more complicated or risky, so I wonder what your options would be there.
I was on remicade (it gave me psoriasis which was bizarre) and getting a bad infection is scary (I’m on another immunosuppressant). I hope he feels much better!
The few times I have had a sinus infection I described it at as feeling like I had been punched in the face. And that was a run of the mill, doctor visit with some antibiotics and maybe some nasal sprays. I can only imagine how miserable poor Edward must have felt! Super scary but I’m glad he is doing better!
Poor baby. And poor mama. So scary and hard. I had a sinus infection/recurring sinus infections as a young teen and had to have sinus surgery- it was pretty dang gnarly and I was hospitalized for 2 days to recover. My was not emergency surgery, it was more to address the ongoing problem. But the surgeon did give my mom a big lecture about how serious it had become, and that mine was fungal based and dangerous. I don’t have the added complication of Crohn’s disease. Bless him.
oh my GOSH. I too was curious what had happened here, as a frequent getter-of-sinus-infections, and my GOSH I say. (I have narrow sinus passages as well! it is crappy! i had a “balloonoplasty” or some equally-dopey sounding procedure to try and expand them slightly so they’d stop getting swollen closed so easily. Not sure if that’s an option for E.)
Going through that sort of thing as a patient is no fun, but I cannot IMAGINE going throught that as his mom. All the chocolate for you. All of it.
No history of sinus infection in my household, so my only exposure to the implications prior to your experience was in the entries of another blogger named Julia (any other former Hippogriffs readers here?), whose son had chronic sinus infections and had had to have surgery as well. It was quite awhile ago, but the part that stuck with me was when she said that they’d gone for the surgery because the infection at the back of his sinuses could start eating its way out of the sinus cavity and make it to his brain. So gross and scary!
I’m glad Edward is home and on the mend!