[Wendy Beltrami]

Hi Everyone,

Well, once again, Grant has got the doctors stumped.
Almost 3 weeks ago, he said "mom, I have pimples on my scalp". Yikes, that was an understatement. His head was covered with them and because he has such a thick mop of hair, we really didn't know how long ago they had started. A culture was done and it came back as expected- folliculitis/staph. No fever and ANC was 1100.
So, he was started on doxycycline. He had no other symptoms, just these painful, gross looking, pus filled bumps. An anti fungal shampoo and a steroid lotion finally started clearing them up after about 5 days. HOWEVER, then they began to spread, his chest, back and face was erupting with these lesions.
On to the dermatologist. By this time, he'd been on the antibiotics fo 12 days. A biopsy was done on one of the new spots, as now it was feared that perhaps the staph was the dreaded MRSA, although the first culture had not shown that species. Nope, culture was clear. No infection. Okayyyyy.
He is still dependent on platelets and rbcs and clearly the low platelets were hindering the healing of the spots.
So, he got platelets on Saturday and Saturday night starts having a fever. Blood cultures Sunday morning- nope. Clear. CBC still shows ANC of 1100. Chem panel looks fine. Now he's having lower back pain and his toe hurts!
No redness, no new eruptions. He says it feels like the serum sickness he had after ATG. Fever subsides during the day and has come back now 3 evenings in a row. Doxycycline was stopped today.

Anybody want to take a stab at a diagnosis/cause?

Wendy/mom to Grant age 15 1/2
dx 12/4/98 AA