Marcella's Story: Parent's Letter Project Sterile abscess- Marcella’s mom

While giving a bath to my 18 month old daughter, I felt a hard bump on her right thigh. I hope to share this experience to assure you that the doctors at Children's National will do their best to help your child.

Right after finding the bump, I took my daughter to the pediatrics clinic for a walk-in appointment. The initial diagnosis was a deep bruise, but the doctors wanted to make sure it was not something more serious and ordered an X-ray and an ultrasound. The X-ray showed that the bump was not near the femur (thigh bone), which made me feel a bit better. The ultrasound revealed a subcutaneous mass, but the radiologist could not tell what it was or what could have caused it. When I saw the bump on the ultrasound screen, it looked to me like a dark 1.5 inch (in diameter) disk or patty.

When we returned to Children's National the following week for a follow up appointment, the bump was still there -- it had not dissolved like a hematoma would have. The pediatricians issued a referral to General Surgery. Walking across the hospital to the surgery department to make an appointment was a scary experience. I was very worried for my daughter.

Fortunately, the Chief of Pediatric Surgery was available right then and he examined my daughter. Anthony Sandler, MD, reviewed the case, asked questions, listened to my concerns, and ordered a MRI to find out more about the bump. Dr. Sandler and his staff worked with Radiology so that my daughter did not have to wait a long time to get a MRI with sedation -- little kids need anesthesia for MRIs so that they don't move or cry while the MRI machine runs the test. The day after the MRI, Dr. Sandler called me at home (on a Friday at 6:30 pm) to say that he felt reassured with the MRI results, that my daughter most probably had a lymphatic malformation on her thigh, and that this was something that could be operated on without major complications.

On the day of the surgery, we arrived at Children's National very early (5:45 am) and were treated very well. The surgical staff were wonderful. My daughter felt comfortable and blew kisses at the nurses and the anesthesiologists. She shook hands with Dr. Sandler and gave him a big smile. After the surgery, Dr. Sandler explained to us that the bump was a sterile abscess, not the lymphatic malformation he had expected to find.

An abscess is a localized collection of pus in any part of the body, usually caused by an infection. Abscesses occur when an area of tissue becomes infected and the body is able to "wall off" the infection to keep it from spreading. Although the majority of abscesses are septic (i.e. caused by an infection), sterile abscesses, which are not caused by germs but by non-living irritants such as drugs, can also occur. My daughter's abscess was probably caused by a vaccination that was not fully absorbed, stayed where it was injected, and caused enough irritation to generate a sterile abscess.

What I wish to convey to parents who find a "mystery" bump is that the doctors at Children's National not only are the best in their medical fields, but they also care for their patients. My daughter's doctors took prompt action to find out what was wrong, and they did so in a caring manner.

Although this was a scary experience -- with fortunately a happy ending and only a faint scar -- I am very happy that I took my daughter to Children's National. All the best doctors and diagnostic tools are under one roof.

Sincerely,

Marcella's mom, Maria

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