Red Spots & Itching

[hawk6868]

Hello,
It has been about 2 weeks since my wife Cindy had her normal 900 mg clindamycin IVs 2 per day 5 days. For the last few days Cindy had her mouth swell up and turn red, and lots of white and red spots from her knees down to her feet. She also has several red spots under her arms. All the red spots are itching like crazy! What can she do to stop or reduce the itching??? Does this sound like she is herxing from the IV treatment?

She has taken several of these IV treatments before and only once back in 2004 did she have the red spots on her legs.

She has always taken the 2 100mg mino’s per day with no problem. Then her legs got very dark from the pigmentation, and she got a black mustach from the pigmentation from the mino. So for the last year she has been taking Doxy instead of the mino, and most of the darkness has gone away. I’m guessing all this herxing she is going thru is because the Doxy didn’t kill as much of the micoplasma cells, but the IVs are killing a lot more of them now. Does that sound reasonable to you guys? She will be going back on the Mino very soon. After being on the Mino for 8 years we thought it was losing its effectiveness.

Thanks everyone!

[Maz]

Hi Bob,

Can you share your wife’s diagnosis and anything else she may be taking?

Also, is she seeing an experienced AP Physician?

Thanks!

[hawk6868]

Thanks Maz!
Cindy has CREST syndrome since 1991. She started AP with Dr. S in 2004.

She takes Azithromycin 500mg twice a week, Doxycyline 100mg twice day 5 days week, and the clindamycine 900mg 2 IVs per day for 5 days every 6 months.

The swelling in her mouth has went down, but she has been scratching her legs for several days.

I will call Dr. S today.

[Maz]

@hawk6868 wrote:

It has been about 2 weeks since my wife Cindy had her normal 900 mg clindamycin IVs 2 per day 5 days. For the last few days Cindy had her mouth swell up and turn red, and lots of white and red spots from her knees down to her feet. She also has several red spots under her arms. All the red spots are itching like crazy! What can she do to stop or reduce the itching??? Does this sound like she is herxing from the IV treatment?

She has taken several of these IV treatments before and only once back in 2004 did she have the red spots on her legs.

She has always taken the 2 100mg mino’s per day with no problem. Then her legs got very dark from the pigmentation, and she got a black mustach from the pigmentation from the mino. So for the last year she has been taking Doxy instead of the mino, and most of the darkness has gone away. I’m guessing all this herxing she is going thru is because the Doxy didn’t kill as much of the micoplasma cells, but the IVs are killing a lot more of them now. Does that sound reasonable to you guys? She will be going back on the Mino very soon. After being on the Mino for 8 years we thought it was losing its effectiveness.

Hi Hawk,

Hopefully, you’ve managed to make a contact with Dr. S. by now. As your wife has had this reaction to IV clindy before and she is seeing Dr. S., who is very experienced, my thoughts are that if he was aware of the prior reaction, then he must not be too concerned? Just surmise on my part, but nevertheless, the reaction this time around sounds severe enough and worse than the first time, so very important to mention this to him in case this is more than herxing and she has developed an allergy. Steven Johnson syndrome can be very severe and life-threatening, with mouth ulcerations, skin rashes and conjunctivitis, so I always think it’s better to check any reaction with the rxing doc just to be on the safe side.

There are other reactions to abx that can show up, like systemic candida, which can cause oral lesions like you’re describing as well as itchy red/white skin rashes. Hives (uticaria) can also produce itchy bumps and wheels on the skin.

Pic of hives here: http://en.wikipedia.org/wiki/Hives

Pic of oral candida: http://en.wikipedia.org/wiki/Oral_candidiasis

Am sure there may be other causes of rashes from various abx, including clindamcyin, so probably not limited to the above. If you can take a digital pic of the rashes to send Dr. S. then this would likely give him a better idea of what your wife is dealing with, too. It’s always worthwhile documenting any rashes like this and keeping a dated folder for future reference, if needed.

Here is a link on Wiki to Clindamycin. It’s worth reading the whole link, especially the section on adverse reactions. Generally speaking, this abx is really well tolerated in most people and quite safe, only producing allergic symptoms in about 1% of people who have taken it. And only 0.1% chance of serious anaphylaxis and other serious complications, so pretty rare, all in all:

http://en.wikipedia.org/wiki/Clindamycin#Adverse_effects

“Adverse effects

Common adverse drug reactions associated with clindamycin therapy

[hawk6868]

Cindy thinks she is improving with the rashes and itching. She has been putting Monistat gel on the her legs and it has been preventing the itching much longer than body cream. Her mouth is much better, but she did wake up this morning with her left ear inflamed and a knot on the side of left cheek bone. She thinks this is from a bug bite last night. I have tried calling Dr S once but didn’t get through. I will send him an email.

Thanks for the detailed response Maz!

[Maz]

@hawk6868 wrote:

She has been putting Monistat gel on the her legs and it has been preventing the itching much longer than body cream. Her mouth is much better, but she did wake up this morning with her left ear inflamed and a knot on the side of left cheek bone. She thinks this is from a bug bite last night. I have tried calling Dr S once but didn’t get through. I will send him an email.

Hi Hawk,

Glad Cindy is doing a little better and interesting that the Monistat gel is helping her leg rash. Might be a good idea to get her tested for candida overgrowth. Perhaps her GP would do that? It’s possible that if this is systemic candida that she’d need a systemic anti-fungal med prescribed for a while. Such a shame to be left suffering like this when it might be helped.

Hope Dr. S. gets back soon! Please let us know what he thinks. Will keep Cindy in my thoughts.

[Author]

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