I'm a 16 year old with a history of recurrent shin lesions with low grade fever and tachycardia. I had 2 short stay admissions (29/1/11 & 4/2/11) at the emergency department for the above, which was treated as cellulitis and I was put on IV antibiotics. Just recently I was admitted a 3rd time due to reoccurring shin lesions in opposite leg, lower abdominal pain and loose bowel motions. With this third admission, I spent a total 17 days in hospital, 16 of those were spent on an IV drip. On the 13th day I underwent a endoscopy and colonoscopy which confirmed my diagnosis with Crohns disease. I was definitely an 'interesting' case for the Doctors, so here's my story. (Sorry if it’s poorly written, it’s quite late where I am!)
It all started late January this year. I'd just come home from a relaxing 12 day cruise around New Zealand. As I was leaving to fly home, I kicked my shin on a hard-plastic chair. It was extremely painful at the time, but I'd soon forgotten about it.
3-4 days later an egg-shaped lump appeared on my right shin. 1 week after the knock, redness started to appear. Over the next few days, it became hot to touch and both redness and swelling increased. I saw my GP, who took a quick glance and diagnosed it as an infection, and I was sent home on antibiotics.
The next day my leg had gotten worse, to the point where I was unable to even walk on it. At this stage, both my parents insisted I went to the hospital and had it looked at. The doctor at Emergency diagnosed it as celulitis (infection in the skin) and I was started on some IV antibiotics for the next 24 hours. I was then sent home on Staphlex 250mg. For about the next 2 days the lesion had reduced in both redness and in size. Though soon after it flared up again and had now spread to the point where it covered almost my entire shin.
1 week after my previous admission, I returned to Emergency. I was put on the IV antibiotics again, for about 40 hours. This time they alternated between the IV and oral antibiotic. I had an allergic reaction to one of them (Clindamycin). The lesion improve significantly and I was sent home with 2 weeks worth of Staphlex 500mg. I had no problems for several weeks now.
Then a month later I was at work, and in a matter of hours a lesion appeared on the OPPOSITE left shin with full-on redness and swelling. At this same time I'd also had diarrhea (thought this may have been because of the antibiotics), slight chest pain, cramping in my abdomen on the lower right hand side, and pain around the hip. I actually thought I might have had appendicitis.
So I returned to the Emergency department for a 3rd time. They immediately started me on the antibiotics, and because of the unusual reoccurrence in the opposite leg and my other symptoms they looked into everything a lot further. During my first week in hospital I felt like I'd had every test imaginable. (multiple x-rays, ultrasounds, cat scans etc.) You name it, I was tested for it.
A lot of stuffed happened during the 17 days of being hospital, that even I'm hard pressed remembering. So trying not to blab on too much more, I’ll simply type out my discharge summary.
- admitted to hospital on 5/3/11
- commenced on IV flucloxacillin
- investigated by medical team (ANA, dsDNA, ENA, ANCA, B12, folate, iron studies, septic workup)
- USS abdomen (complex heterogenous collection in RIF may represent thickened wall or inflamed terminal ileum/caecum)
- changed IV antibiotics therapy (ampicillin, gentamicin metronidazole
- DVT prophlyaxis given as impatient
- V/Q scan performed 8/3/11 (no evidence of PE)
- CT abdomen (complex heterogenous lesion in caecum/ascending colon with lymphadenopathy; lack of terminal ileum involvement)
- surgical team involvement
- gastroenterology involement to lx ?Crohn’s
- echocardiogram performed on 10/3/11 (no evidence of infective endocarditis)
- colonoscopy and endoscopy performed on 17/3/11 (likely Crohns, see biopsy report)
- dermatology review 17/3/11 (likely erythma nodosum)
- commenced on oral prednisolone 40mg and 6-MP 50mg
- Fe infusion given on 21/3/11
- Pt subsequently discharged home with d/c medications, medical certificate and follow-up arrangements in place. (40mg 1/52, 30mg 1/52, 20mg 4/52, then reduce by 2.5mg each 1/52)
Whilst in hospital I was also diagnosed with AIS scoliosis. I didn’t find out in the most pleasant way either. The lady who had taken my chest x-ray casually said to me “So your being treated for your scoliosis” and I said “Urgh…what scoliosis?!” Then she had a bit of shocked look on her face and told me to mention it to the doctors next time I saw them. Mind you, this was at 11 o’clock at night..so of course, I freaked out! Both the doctors and my parents were really unimpressed with the radiographer and the way she approached me.
I'm back at school now and feeling fine. I found the initial first week after being discharged the hardest, as it was a huge shock for me. I wouldn't be able to talk to anyone about it without bursting into tears (not sure if the preds were partly to blame for this). Other than that, I'm responding to my medication really well and haven't experienced any problems/symptoms since being in hospital.
Anyway, I hope I didn't bore you with my story too much and I look forward to talking to you all in the near future. I think I'll definitely benefit from this forum a lot, especially during those rough stages.
It all started late January this year. I'd just come home from a relaxing 12 day cruise around New Zealand. As I was leaving to fly home, I kicked my shin on a hard-plastic chair. It was extremely painful at the time, but I'd soon forgotten about it.
3-4 days later an egg-shaped lump appeared on my right shin. 1 week after the knock, redness started to appear. Over the next few days, it became hot to touch and both redness and swelling increased. I saw my GP, who took a quick glance and diagnosed it as an infection, and I was sent home on antibiotics.
The next day my leg had gotten worse, to the point where I was unable to even walk on it. At this stage, both my parents insisted I went to the hospital and had it looked at. The doctor at Emergency diagnosed it as celulitis (infection in the skin) and I was started on some IV antibiotics for the next 24 hours. I was then sent home on Staphlex 250mg. For about the next 2 days the lesion had reduced in both redness and in size. Though soon after it flared up again and had now spread to the point where it covered almost my entire shin.
1 week after my previous admission, I returned to Emergency. I was put on the IV antibiotics again, for about 40 hours. This time they alternated between the IV and oral antibiotic. I had an allergic reaction to one of them (Clindamycin). The lesion improve significantly and I was sent home with 2 weeks worth of Staphlex 500mg. I had no problems for several weeks now.
Then a month later I was at work, and in a matter of hours a lesion appeared on the OPPOSITE left shin with full-on redness and swelling. At this same time I'd also had diarrhea (thought this may have been because of the antibiotics), slight chest pain, cramping in my abdomen on the lower right hand side, and pain around the hip. I actually thought I might have had appendicitis.
So I returned to the Emergency department for a 3rd time. They immediately started me on the antibiotics, and because of the unusual reoccurrence in the opposite leg and my other symptoms they looked into everything a lot further. During my first week in hospital I felt like I'd had every test imaginable. (multiple x-rays, ultrasounds, cat scans etc.) You name it, I was tested for it.
A lot of stuffed happened during the 17 days of being hospital, that even I'm hard pressed remembering. So trying not to blab on too much more, I’ll simply type out my discharge summary.
- admitted to hospital on 5/3/11
- commenced on IV flucloxacillin
- investigated by medical team (ANA, dsDNA, ENA, ANCA, B12, folate, iron studies, septic workup)
- USS abdomen (complex heterogenous collection in RIF may represent thickened wall or inflamed terminal ileum/caecum)
- changed IV antibiotics therapy (ampicillin, gentamicin metronidazole
- DVT prophlyaxis given as impatient
- V/Q scan performed 8/3/11 (no evidence of PE)
- CT abdomen (complex heterogenous lesion in caecum/ascending colon with lymphadenopathy; lack of terminal ileum involvement)
- surgical team involvement
- gastroenterology involement to lx ?Crohn’s
- echocardiogram performed on 10/3/11 (no evidence of infective endocarditis)
- colonoscopy and endoscopy performed on 17/3/11 (likely Crohns, see biopsy report)
- dermatology review 17/3/11 (likely erythma nodosum)
- commenced on oral prednisolone 40mg and 6-MP 50mg
- Fe infusion given on 21/3/11
- Pt subsequently discharged home with d/c medications, medical certificate and follow-up arrangements in place. (40mg 1/52, 30mg 1/52, 20mg 4/52, then reduce by 2.5mg each 1/52)
Whilst in hospital I was also diagnosed with AIS scoliosis. I didn’t find out in the most pleasant way either. The lady who had taken my chest x-ray casually said to me “So your being treated for your scoliosis” and I said “Urgh…what scoliosis?!” Then she had a bit of shocked look on her face and told me to mention it to the doctors next time I saw them. Mind you, this was at 11 o’clock at night..so of course, I freaked out! Both the doctors and my parents were really unimpressed with the radiographer and the way she approached me.
I'm back at school now and feeling fine. I found the initial first week after being discharged the hardest, as it was a huge shock for me. I wouldn't be able to talk to anyone about it without bursting into tears (not sure if the preds were partly to blame for this). Other than that, I'm responding to my medication really well and haven't experienced any problems/symptoms since being in hospital.
Anyway, I hope I didn't bore you with my story too much and I look forward to talking to you all in the near future. I think I'll definitely benefit from this forum a lot, especially during those rough stages.