Entering the house through our sliding glass doors, calling my name, and using her finger to draw my attention to her chin, Eliana declared, “ I have a boo boo.” This rough and tumble kid of mine rarely comes in just to report a scrape, so I was curious to see what this was really about.
Eliana is an amazingly observant child. She has noticed every important change in all of her pets before I ever did, and it occurred to me that perhaps she was confused, rather than hurt, by presence of this very small wound tucked underneath her chin.
Eliana didn’t know where it came from and I couldn’t tell what might what caused it. It was pink and circular with a diameter about the same size as a pencil’s eraser. There were no scratch marks, signs of physical impact, bruising, or scabbing. It looked fresh, similar to a tiny rug burn, maybe a blister. It was raw in the middle, mildly red around the edges, and it was confusing to both of us that she didn’t remember anything happening that could have caused it.
We washed her chin and put some antibiotic ointment over it. I kissed her forehead and she went on her merry way, running back outside to play.
By the next morning the area looked like it might have been a little larger and by evening it was obvious that it was growing. It still did not hurt her and instead of a typical dark scab, I could see what looked like a lightly colored patch of skin surrounded by previously healthy skin turning red. That evening, after Eliana went to bed, I called Fred, who was back in the states working. He didn’t know what it could be and told me to use a pen to circle its current size and call him with an update the next day.
By Sunday morning when Eliana woke up there was no need to circle the area. Something strange was going on and I wasn’t going to wait and see much longer. The spot, measuring 1.5 cm in diameter, consisted of lightly tinted skin resembling a transparent scab, through which I could see the wound underneath. I got smart and took pictures to send to Fred via email.
That afternoon, while worrying that this wound could spread over the rest of her face, I remembered an article I read in June while researching possible causes to Eliana’s squirted burn. A Nicaraguan woman had contracted a flesh eating bacteria that had taken over her hand. She had waited too long to seek treatment and it was believed her hand would need to be amputated. Ugh, get me to the doctor yesterday!
I suddenly wished I could drive in warp speed to the nearest privately funded clinic, just 15 minutes from here, and a hop, skip, and a jump past the entrance to Eliana’s school. I had seen enough to know this wound wasn’t going to go away on its own and my mind was getting carried away. I needed to squash the “what ifs” and get answers. We entered the lobby and waited less than 10 minutes to be seen.
We knocked on the doctor’s door. “Adelante,” (come forward).
We entered the doctor’s office and sat down side by side in two chairs facing the doctor, who sat at his desk facing us as we entered. He did not rise to greet me nor offer to shake my hand. I started speaking in Spanish, then stopped and asked him if he spoke English. “No,” he replied. “It’s better that you learn to speak Spanish. Learning English is difficult and I don’t have much time to practice.”
I described the symptoms while he motioned for Eliana to walk around to his side of the desk so he could inspect her chin. He knew exactly what it was…the aftermath of what I like to call, “the pissing beetle”. The doctor, however, just called it the maya. “¿Lo conoce?”
“Yes, I know what it is,” I answered, as a slight panic entered my stomach. I read about this little bugger when researching possible causes for Eliana’s squirted burn. Remember the flesh eating “bacteria” consuming that woman’s hand? That, my friends, was the work of the maya. It’s precisely what I feared had happened, and I forced myself to pay acute attention to the doctor’s delivery and his overall vibe. I noticed that the doctor didn’t seem alarmed, and I remembered to breathe…and breathe some more.
The maya is a beetle that secretes a caustic liquid. The locals, and the doctor, say it urinates. They could be right, I don’t know, it’s really difficult to research the characteristics of a beetle when no one can tell you its name in English. The “urine” eats away at the skin, and the wound grows larger and larger, spreading over vast areas if left untreated. It took a lot of researching, and while I did not find a definitive answer, I do believe that in English we call these bugs blister beetles. If so, then the “urine” is secreted by the males to give to the females during mating, which is then used to cover and protect the eggs. There are 300 species in the U.S. alone, and thousands world-wide (Spanish Fly sound familiar?), so which type we have down here, I don’t know. The doctor was grateful I brought her in right away, explaining that these infections are difficult to treat once they get large. I’m quite certain I was feeling infinitely more grateful than he was.
Eliana was prescribed a triple purpose cream which contained an antibiotic, antifungal, and a steroid. The doctor rubbed in a thin layer on the wound while he instructed me to clean away all of the yellow (newly formed & infected) skin and apply the cream twice a day. The visit and medicine together cost me roughly $13.
Let’s just say that wound care is not for the faint of heart. Eliana instinctively knew how to respond to the pain by initiating lamaze breathing tactics as I soaked, scrubbed, and pulled away the skin. She cried and requested breaks when she need to regain her strength. Cleaning the skin away on its own was difficult for her in and of itself, but in the aftermath of her car crash, which had happened just 4 short days prior, she was really at the end of her trauma rope.
We got the wound cleaned and I sent pictures to Fred. He ran by the diagnosis with docs at work who believed that the wound, once healed, would leave no scar. We applied a thick layer of the medicine three times a day (you know, to be safe) and not only did the wound stop growing immediately, it stopped trying to heal itself with infected skin and just gradually started looking healthier and healthier.
You can still see where the wound was. The scar continues to fade and she doesn’t talk about it or worry about it. As for me, well…I’m holding on to the rest of that cream. I may just stock up on it and spread it all over her as a lotion for preventative measures. Just kidding…I think.