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Old 10-30-2009, 01:43 PM
landzsmum landzsmum is offline
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Default Rash around stoma?

Lily has developed a rash around her stoma. Red raised bumps and a little pustular looking. ENT thinks it might be a fungal infection and is suggesting nystatin powder. We are new at all this - wondering if any of you have dealt with something similar. Is nystatin ok so close to the stoma?

Lily has been more sleepy in the last few days, not eating so well, and very distressed during trach care. I'm wondering if it's all related to the rash. We just finished a 10 day course of ciprodex drops in the trach for pseudomonas. Now thinking that might have caused a fungal infection.

Have tried to attach a photo. Appreciate the advice!
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Mum to Zoe and Lily, 23-weekers born 03/27/09, 1lb 3oz. Lily trached 07/15/09; acquired supra-glottal stenosis due to intubation and multiple failed extubations. Lily came home to join Zoe on 09/16/09! Double stage LTP 07/22/10 followed by four balloon dilations. Decannulated 12/02/10!

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Old 10-30-2009, 02:06 PM
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nad_d nad_d is offline
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i suffer also from rush arround the stoma, was put medical cream.
after a while it go away. i dont know if this relate to not eating or distress.
the doctor said the infection arround the stoma make the rush.
try to keep the place dry.
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Old 10-30-2009, 03:43 PM
Niff Niff is offline
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We use Batroban for infections/rashes around the stoma. Nystatin is good for yeasty infections, although I don't use any sort of powder around Mackenzie - much less around her stoma. They make Nystatin cream, so you might request that.

I doubt the psuedomonas or treatment of it caused the rash, although I'm sure anything is possible. For Mackenzie, they happen when her dressings have gotten moisted and stayed on her skin that way.... for instance if we have the mist collar turned up a *tad* bit too high.

Typically for Mackenzie, it clears up within 24/48hrs of using Batroban.

HTH
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Old 10-30-2009, 04:06 PM
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Angel 1 Angel 1 is offline
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Hi!

We use nystatin cream around Cheyanne's stoma and change the dressings every 4hrs, as for the psuedomonia cheyanne has antibiotics as it has colonnised in her lungs.

Hope this helps.



Quote:
Originally Posted by landzsmum View Post
Lily has developed a rash around her stoma. Red raised bumps and a little pustular looking. ENT thinks it might be a fungal infection and is suggesting nystatin powder. We are new at all this - wondering if any of you have dealt with something similar. Is nystatin ok so close to the stoma?

Lily has been more sleepy in the last few days, not eating so well, and very distressed during trach care. I'm wondering if it's all related to the rash. We just finished a 10 day course of ciprodex drops in the trach for pseudomonas. Now thinking that might have caused a fungal infection.

Have tried to attach a photo. Appreciate the advice!
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Cheyanne trached @ 10wks due to suglottic stenosis, spider webbing on voicebox, voicebox closed and polyps (growths on voicebox and in windpipe) now suffering with Petit Mal Epilepsy, drop attacks and absence stares. Mic-Key Button. 1st stage LTR complete. 2nd stage LTR complete.
Cheyanne has now got asthma and heart problems.

Now trach FREE.
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Old 10-30-2009, 05:47 PM
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Gretchen(Celia's mom) Gretchen(Celia's mom) is offline
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To use powder near the stoma,, put the powder on a qtip then rub on skin so you don't get any powder in the trach.
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Old 10-30-2009, 07:20 PM
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BennyJam BennyJam is offline
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From what I can tell from your photo, it does look like a yeast rash. Is she scratching at it too? Ben gets yeasty all the time--he's a sweaty little guy and if his stoma area stays damp at all, he gets a yeast rash. We have a standing prn order for lotrimin cream around the stoma and neck as needed for yeast rashes. It works very quickly (redness should start fading within 24 hrs). Keeping the area clean and dry (we change Ben's trach pad 3x per day) is a great way to keep it away.

Haley
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Haley -- Mom to Benjamin (born 4/07: former 25-weeker, BPD, subglottic stenosis, Nissen, G-tube; LTP on 9/1/10 with three grafts), twin sister Claire (4/07), and big brother Matthew (6/04).
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Old 10-30-2009, 07:43 PM
landzsmum landzsmum is offline
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Thanks everyone! Very helpful.

Lily has started drooling, that and her high heat (she can't tolerate lower heat) mist collar make for a pretty damp environment. I change her drain sponge twice a day, but we'll try doing it more frequently.

Oh and she doesn't yet have the coordination to scratch at it, but I bet it's irritating her and causing her to get more upset during trach care.
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Mum to Zoe and Lily, 23-weekers born 03/27/09, 1lb 3oz. Lily trached 07/15/09; acquired supra-glottal stenosis due to intubation and multiple failed extubations. Lily came home to join Zoe on 09/16/09! Double stage LTP 07/22/10 followed by four balloon dilations. Decannulated 12/02/10!

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Old 10-30-2009, 09:57 PM
Jennifer Jennifer is offline
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Default Stoma Rash

We used to use the nystatin powder when my son first came home from the hospital. I eventually got script for the nystatin cream. It seems to work better. Yes if the heat on the humidified trach mask is too high or compressor setting is too high, this could cause a rash. You might want to check & adjust it accordingly.
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Old 11-01-2009, 11:34 AM
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Kaylie Kaylie is offline
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Hi,
so when you say the ENT says it could be fungi has he or she seen it at all, just curious because you really wanna make sure that you use what will work best based on what it could be. i too would try and keep it as dry as possible as well, i know as difficult as this maybe be especially if you are on the heated collar alot. like u said changing the 2x2 more often as so forth, they do have like others have said the nyastatin in cream form .. i hope u can get it under controll, i am sure its bothering her during care thats why she is fussy..
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Old 11-01-2009, 09:36 PM
bryantem bryantem is offline
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We have had both a yeast rash and bacterial rash. We used Nystatin powder and had no problems. I personally prefer it to the cream because it helps to dry up any moisture. I do as Gretchen said- I put it on a q-tip and apply it that way. Also, we don't use drain sponges. Our ENT isn't a big fan of them and I found that the stoma is able to air out better without them.
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