I realize that this is a simplistic statement on the human biome and all, but the basic idea is that bacteria inside us can be dangerous outside us (E. coli is the poster child) or that we have tons of bacteria on us all the time that are normally harmless unless they get a good opportunity (staph). Right?
So my baby has what we thought was a diaper rash and the doc says may be an infection, so we have antibiotic ointment and if that doesn’t work oral antibiotics. Okay, fine. No idea how he got it - maybe a rash got infected? Maybe he got it somewhere else? I assume it’s impossible to even guess without a culture
But how does this not happen all the time? He very rarely even gets a rash, although he sits in his own feces for a non-negligible portion of the day. (I’ve always thought that was because we cloth diaper. ). But he does get rashes sometimes, especially when he’s teething. Why don’t they get infected with all that fecal bacteria?
For that matter, why don’t adults? Anal micro-tears are surely incredibly common, and there are fissures, all that sort of thing - why aren’t they usually deadly? You hear about bedridden people dying from untreated pressure sores - why not from diaper rash also?
Do I understand correctly that diaper rash is like trench foot but with piss & shit?
It’s not really an inside/outside thing. The stomach and intestine have tissue which prevent infections. If your intestine were to be pierced such that E. coli got out of your intestine and into you abdominal cavities, that would be extremely nasty even if it were inside you.
We have skin specifically to protect us from all the nastiness outside our bodies. It’s pretty good at it.
WAG is that if the parents are not neglectful, the diapers will get changed and the skin area will air out often enough to prevent that (usually, with exceptions such as your case). Also, baby poo may not be as nasty in bacterial terms as adult excrement.
The mechanism for bedsores and diaper rash are rather different. Bedsores deprive tissue of oxygen and other elements carried by the blood. The protective qualities of epithelial cells will not help you there. Also, my guess is that people who die from bedsores were in pretty bad shape already.
We don’t know. See also, anal fissures and burst hemorrhoids, which are much closer to the e.coli, but only rarely become infected with it. Yet take that same feces and smear it on a cut on your arm, and localized infection is pretty likely.
There appears to be something unique in the immune system around the genital/perianal area that helps it fight off infection from fecal bacteria more than the rest of our bodies, but last I knew, we weren’t sure yet what that is.
There are all kinds of commensal (“friendly”) micro-organisms in that area, and part of their job is to protect us from all those nasties. That’s especially true for assorted vaginal colonizations in women; wiping those out leads to yeast infections.
Bedsores are often more the result of impaired circulation than exposure to filth alone, although the really horrible ones can be a combination of both.
As for diaper rashes in people of any age, as long as the skin is intact, it’s unlikely that it will become frankly infected. It also sounds like the OP’s child’s issue may be some kind of suprainfection besides a simple diaper rash.
p.s. YMMV of course, but I’ve always heard that cloth-diapered babies are less likely to have severe diaper rash.
Also, humans seem to have a fair amount of immunity to their own resident bacteria. Much less to that from others.
For illustration, most home kitchens are not maintained as clean as restaurant ones are. But ‘food poisoning’ is much more reported from restaurants or pot-luck/picnic events than in people’s homes.
IANAD, mother of two and grandmother of two. Simple diaper rash is caused by friction and irritation from things like urine, feces and/or cleaning agents. The acidity in feces and urine can change because of changes in diet. In extreme cases it’s actually an acid burn. It is also possible for the poor baby to get a yeast infection (candida). I’ve never seen an actual bacterial infection. Obviously, some babies’ skin is more sensitive than others’.
In my own experience, babies in cloth diapers are less likely to get diaper rash, especially if they are changed frequently. Personally, I would be suspicious of a diagnosis of bacterial infection. Antibiotics CAN make yeast infections worse.
You can get more information from webmd and similar sites. Just do a search for “diaper rash.”
He’s much better now with the cream, actually, as of this morning. (My understanding is that yeast looks different.) This was blistery and the vet said it could even be impetigo. I’m just really glad because I didn’t want to have to do the oral antibiotics because then he probably would get yeast.
It’s a good thing this popped up before he got his 12 month shots or I’d honestly worry that it could be a response to the live vaccines - it looks completely unlike the few rashes he’s had before, none of which have ever been blistery.
What I can’t figure out is how it goes away so quickly. My daughter can have a horrible rash, I put some cream on it, and the next day it’s like it never happened. How does that work?
