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*Please be aware that information provided on this website is for your further education only. It is not to replace the medical care you would receive from our office in response to specific symptoms and questions. If you have any questions, call the office.
In general, most rashes are viral in nature or the result of contact with a skin irritant. Rashes often appear and disappear without any treatment. Call the office if your child has a fever with the rash, the rash is hive-like in appearance, or if the rash is spreading or appears infected. - plant that emits the oily
irritant, urushiol. The urushiol chemically “locks on” to skin proteins
within 20 minutes after exposure to the plant.
Contact with this annoying oil produces a rash in three out of four
people. Symptoms include:
The
best treatment is prevention, however if you find yourself with the rash,
treatment includes: cool soaks to affected area, 1% hydrocortisone cream
twice/day for 3 days. Cut
fingernails short to prevent infection from scratching.
Benadryl orally may be used to decrease itching. Contagion:
The fluid from the sores is not contagious. However, anything that has poison ivy oil or sap on it is
contagious for about one week. This
includes shoes and clothes the patient wore, as well as any pets with oil on
them. Wash items with soap and
water. The rash begins 1 to 2
days after contact. Prevention includes learning to recognize the plant.
Poison Ivy
Wear long pants or socks when walking through the woods. If you think you have come into contact with this plant wash any
exposed areas of skin several times. Try to do this within one hour of
exposure. Need
to be seen if poison ivy
is on
the face, eyes or lips or if with
signs of infection
(pus or soft yellow scabs).
Poison sumac and Poison oak contain urushiol also so be aware of these plants too.
Many infectious diseases are transmitted by ticks. Lyme disease is the best known, but others that may not sound so familiar include Rocky Mountain spotted fever, tularemia and tick paralysis. Not all ticks carry disease, and not all that can make your child sick, will. Here are some precautions you can take when outdoors, especially in wooded areas and grasslands.
~Contemporary Pediatrics May 2006
Lyme disease is caused by a bacteria transmitted to humans through tick bites. Left untreated, it can lead to heart problems, neurological symptoms or arthritis. Most reported cases are concentrated in the coastal Northeast and mid-Atlantic, as well as Wisconsin, Minnesota and Northern California, but the disease has been reported in nearly every state. Outbreaks tend to occur in summer and early fall. Deer ticks are so small that they can be difficult to see, so you may not realize you've been bitten. The telltale sign of infection is a red expanding rash (usually at the location of the bite) that swells to form a circular or oval shape, like a bull's eye. This rash can show up three to 30 days after transmission and is usually not painful or itchy. Other signs may include fever, headache, muscle and joint pain, stiff neck, sore throat, fatigue and changes in vision. Treatment usually involves a three week course of antibiotics which often provides a full cure. Although many ticks don't carry Lyme disease, bites should be monitored. Carefully remove the tick. Your chances of contracting Lyme disease are greatly reduced if you remove the tick within 24 hours. Studies show that transmission does not occur until 36 to 48 hours after the tick attaches to your body. If symptoms occur, see your doctor immediately. ~Centers for Disease Control
The incidence of west nile virus infection has decreased since 2002 as more people are exposed to bites from the mosquitos that carry it. The virus still remains dangerous for the very young and the elderly.
West
Nile virus is spread to humans, birds and animals by the bite of an infected
mosquito. The mosquito becomes
infected from biting a bird with the virus.
Crows and bluejays are the birds most likely to die from the infection. If
you find one of these dead birds contact your local health department in case
they want to test the bird for the virus.
To dispose of the bird wear rubber or plastic gloves or use a shovel to
pick up the bird. Place the bird
in a plastic bag, tie it shut and place inside another plastic bag and close.
Wash hands well when done. Most
people infected with Symptoms
are generally mild and include: fever,
headache, body aches, skin rash and swollen lymph glands.
Severe infections are marked by high fever, neck stiffness, stupor,
disorientation, coma, occasional convulsions and paralysis. Prevention
is the key to avoid infection. You
can reduce the number of mosquitoes around your property by eliminating areas
of standing water. Turn over
wading pools when not in use, dispose of cans or containers that hold water.
Clean birdbaths weekly. Aerate
ornamental ponds or stock with fish. Wear
light colored clothing, long sleeved shirts or jackets and slacks. Use
insect repellent with Deet (6-30%)
for children when outdoors. Remember
to wash off when come inside, spray onto clothes rather than skin. Stay
indoors if possible when mosquitoes are most active, generally two to three
hours before and after dusk and at dawn when the air is calm.
This is when the females are most likely to bite. For
more information go to the
This is a sore throat caused by the streptococcus bacteria. It can only be diagnosed with a rapid strep test or a throat culture. Symptoms often include fever, complaints of a sore throat, headache or stomachache. If your child has any of these symptoms for longer than 24 hours they should be seen to be tested for strep. Untreated strep throat infections can have serious complications such as rheumatic fever. Strep throat is usually treated with penicillin. Generally, after being on the antibiotic for 48 hours symptoms have improved. After taking the antibiotic for 24 hours, your child is no longer contagious and can return to school if the fever is gone and they feel better. Tylenol or Motrin can be given along with the antibiotic to treat fever or for pain relief. Warm salt water gargles and a soft diet are also helpful. The incubation period after exposure is 3-5 days. Anyone in close contact that develops symptoms during this time frame should be tested for strep throat.
This is a strep throat infection with a rash. The rash is caused by a special rash-producing toxin that is present in some strep bacteria. The rash usually appears 18-24 hours after developing a sore throat and a fever. The skin appears sunburned, with very small red bumps and it feels rough, like sandpaper. The rash usually clears in 4-5 days after treatment with penicillin. Occasionally the skin will peel where the rash was most prominent. Your child is no longer contagious after being on the antibiotic for 24 hours. The rash itself is not contagious.
Most sore throats are caused by viruses and are part of a cold. Tonsillitis (temporary swelling and redness of the tonsils) is usually present with any throat infection, viral or bacterial. The presence of tonsillitis does not have any special meaning. Sore throats caused by a virus usually last 3-4 days. Children with a postnasal drip from draining sinuses often have a sore throat from frequent throat clearing. Treatment for sore throats include: Tylenol or Motrin for pain and fever relief, warm salt water gargles and a soft diet. Your child should be seen if the pain is severe, or if they are experiencing a great difficulty in swallowing, or are drooling or spitting.
Roseola is a viral rash caused by the human herpes virus6. This virus generally affects children ages 6 months to 4 years of age. The rash is a fine, pink rash on the trunk of the body. The rash is preceded by 2-3 days of fever. The fever goes away and then the rash appears. There is no treatment necessary other than fever management. The child is contagious while with the fever and until the rash is gone usually in 1-2 days.
A bright red rosy rash on both cheeks for 1 to 3 days (slapped cheek appearance). Rash on cheeks is followed by pink “lacelike” rash on extremities, mainly on thighs and upper arms. The rash can come and go for a period of 1 to 3 weeks. Usually no fever or with a low grade fever.
This illness is caused by the human parvovirus. It is a mild illness with few other symptoms. The incubation period is 10-14 days after exposure. This illness is mainly contagious the week before the rash begins. If you are pregnant and exposed to a child with fifth’s disease contact your obstetrician.
Treatment: No treatment is necessary. The distinctive rash is harmless and causes no symptoms requiring treatment.
Injuries: Abrasions, Cuts/Lacerations, Falls This is the season of outdoor activities which means the number of injuries increases significantly. Maintaining outdoor equipment in proper working order and wearing appropriate safety gear will help to reduce injuries. Treatment for the most common injuries is as follows: Abrasions: These result in injury to the top layer of the skin. Treatment: Cleanse with an antibacterial soap, apply antibiotic ointment and observe for signs of infection: increased redness, tenderness, swelling or discharge at the site. Cuts or Lacerations: These are generally deeper, more irregular wounds. Depending on the wound these may require sutures. Treatment: If the wound won't stop bleeding after pressure is applied or if the wound is gaping (like a buttonhole) it is recommended to seek treatment at an emergency department for possible suture closure. Falls: These accidents can result in the above injuries and also could include fractures and serious head injury. Fractures: If your child has sustained a fall or trauma and is unable to move an extremity, has limited range of motion, bruising, swelling or point tenderness at the site of the injury, they should be seen at an emergency department for radiographic evaluation of the injury. Head Injury: If your child has sustained a fall or blow to the head it is important to assess for signs of serious head injury. These include: - loss of consciousness. - persistent headache or vomiting (greater than two times) - clumsiness or inability to move a body part - abnormal speech or behavior - oozing of blood or fluid from ears and or nose - convulsions If your child exhibits any of these symptoms following a head injury call 911 or seek treatment at an emergency department. If your child has none of the above symptoms, apply ice to the injured area and observe for the above signs of a more serious head injury. It is not unusual to see a lump form over the injured area. This is normal and could last for several days.
Pinworm infections are caused by a small, white intestinal worm. Pinworms live in the rectum of humans. While an infected person sleeps, the female leaves the intestine through the anus and deposits eggs on the surrounding skin. The main symptoms of infection are rectal itching, disturbed sleep and irritability. Pinworms are the most common worm infection in the United States. School age children have the highest rate of infection. The mode of transmission is the fecal-oral route. You can become infected after ingesting infective pinworm eggs from contaminated surfaces or fingers.
Diagnosis: Checking the rectum at night or first thing in the morning could reveal the presence of adult worms. These will appear as tiny white threads. Occasionally, worms are seen in the stool of infected persons. If you have found worms on your child call the office for treatment.
Treatment: Pinworms are treated with prescription medication which is a two dose treatment. Close family contacts may also require treatment. To prevent the spread of infection: change and wash your underwear each day, change pajamas frequently, trim fingernails short, encourage good hand washing after using the toilet, before eating and after changing diapers. Discourage nail biting and scratching of bare anal areas, these practices help reduce the risk of continuous self infection. After diagnosis, linens and towels of the infected person should be washed in hot water. Vacuuming the entire house or washing sheets everyday are probably not necessary or effective. ~Centers for Disease Control
Fever
is the body’s defense against illness and the body’s natural way of fighting
infection. The main reason to reduce
fever is to make the child more comfortable.
If fever causes discomfort for your child, you may give acetaminophen
(Tylenol) every four hours, or, if
your child is over 6 months of age, ibuprofen (Advil, Motrin) every 6
hours. Do not alternate acetaminophen and ibuprofen to treat fever. Contact
the doctor if your child: -has
a temperature of 100.4 (rectal) in an infant under 8 weeks of age -has
had the fever for 3 days with no other symptoms -has
had the fever for 24-48 hours with other symptoms of illness (ie. cold
symptoms, cough, urinary frequency, sore throat, etc.)
A cold or upper respiratory infection is a viral infection of the nose and throat. These viruses are spread from one person to another by hand contact, coughing and sneezing - not by cold air or drafts. Since there are up to 200 cold viruses, most healthy children get at least 6 colds per year. Symptoms include: A runny or stuffy nose, usually has fever, sometimes associated with a cough, hoarseness and red eyes. Expected course: Usually the fever lasts for 3 days, and all nose and throat symptoms are gone by 2 weeks. A cough may last 2 to3 weeks. The main things to watch for are secondary bacterial infections such as ear infections or conjunctivitis. Thick yellow nasal drainage lasting longer than 2 weeks could be a sinus infection in children over 2 years of age. Treatment: The best treatment is clearing the nose for a day or two. Older children should be encouraged to blow their noses. Infants can have secretions removed gently with a soft rubber suction bulb. Fever (over 102 F) can be treated with acetaminophen or ibuprophen. Warm salt water gargles and hard candies can soothe sore throats in children over 4 years of age. Run a humidifier in the child's bedroom to provide extra moisture in the air. Call the Office: If the fever lasts longer than 3 days The nasal discharge last more than 14 days. The eyes develop a yellow discharge. You cannot unblock the nose enough for your infant to take adequate fluids. Your child develops an earache.
Croup is a viral infection of the vocal cords. It is usually part of a cold. The hoarseness is due to swelling of the vocal cords. Stri dor occurs as the opening between the cords becomes more narrow. Croup has a distinctive cough, it is tight and often sounds like a barking seal. The voice is usually hoarse. Croup usually lasts for 5 to 6 days and is generally worse at night. The worst symptoms are seen in children under 3 years of age. Using a cool mist vaporizer in the bedroom will help ease the cough. Warm clear fluids may help relax the vocal cords and loosen mucus. If your child suddenly develops stridor or tight breathing, do the following:
Coughs
are an associated symptom of a cold. Most coughs appear after having
upper respiratory symptoms (colds). In general, if your child does not
have a fever, the cough is not affecting their activity or sleep, and is not
causing respiratory difficulty the symptom should resolve in 5-7 days.
Over the counter cough medicines are not recommended in children under 6 years
of age. Contact the doctor if your child: - has had a cough for several days and then develops a fever lasting longer than 24 hours. - has a cough that is nonstop or causing them to gag - is having any difficult respirations. (wheezing, panting, etc.) Influenza SymptomsInfluenza (commonly called the “flu”) is a contagious respiratory illness caused by influenza viruses. The information below describes common flu symptoms, how to protect yourself and those close to you from getting the flu, and what to do if you get sick with flu-like symptoms. Be Aware of Common Flu SymptomsInfluenza usually starts suddenly and may include the following symptoms:
Having these symptoms does not always mean that you have the flu. Many different illnesses, including the common cold, can have similar symptoms. Diagnosing the FluIt is very difficult to distinguish the flu from other infections on the basis of symptoms alone. A doctor's exam may be needed to tell whether you have developed the flu or a complication of the flu. There are tests that can determine if you have the flu as long you are tested within the first 2 or 3 days of illness. If you develop flu-like symptoms and are concerned about your illness, especially if are at high risk for complications of the flu, you should consult your healthcare provider. Those at high risk for complications include people 65 years or older, people with chronic medical conditions (such as asthma, diabetes, or heart disease), pregnant women, and young children.
RSV (Respiratory Syncitial Virus)
RSV is a virus and the major cause of bronchiolitis (viral infection of the lower respiratory tract) and pneumonia in children less than one year of age. It occurs most often during the winter and early spring. It most often occurs in infants and small children under 2 years of age. It is very communicable, by the time children reach the age of 2 years nearly 100% will have acquired an RSV infection.
Transmission: RSV is acquired by contact with infected secretions, primarily infected hands touching the eyes or nose. It is not an airborne illness.
Symptoms: After exposure, the incubation is 5-8 days. Symptoms include: fever, large amounts of nasal secretions, ear or eye infections and development of a wet, choky cough. As the illness progresses, these symptoms may appear: wheezing, rapid or difficulty breathing and retractions (pulling in of chest muscles when breathing).
Prevention: Good hand washing is the best prevention. Wash toys between each use, cover mouth and nose with a tissue when coughing or sneezing, then wash your hands. Dispose of all tissues in the garbage. Don't share towels or washcloths to prevent the spread from dried secretions.
Treatment: Treatment includes management of the symptoms, use of a cool mist vaporizer, and plenty of rest. If your child's symptoms are worsening or with any difficult respirations call the office to be seen. Some children require hospitalization to manage the respiratory symptoms.
An ear infection is a bacterial infection of the middle ear (the space behind the eardrum). It is usually a complication of a cold. The pain is due to pressure and bulging of the eardrum from trapped, infected fluid. The peak range for ear infections is 6 months to 2 years, but they continue to be a common childhood illness until 8 years of age. Treatment includes an antibiotic to kill the bacteria causing the ear infection. Acetaminophen or Ibuprofen can be given along with the antibiotic to treat fever or for pain relief. Ear infections are not contagious. A follow up appointment in 3 - 4 weeks is needed to be sure that the infection has cleared up. Most vomiting is caused by a viral infection of the stomach and usually lasts 6 to 24 hours. The main concern with vomiting is to prevent dehydration. If your child vomits, do not give anything to drink for one hour. After the hour you may rehydrate slowly with clear liquids (Pedialyte for infants to 2 years), gatorade for children over 2 years of age. Start with a tablespoon of clear liquid every 15 minutes for an hour. If there is no further emesis, gradually increase the amount each hour. If your child vomits again, you must wait an hour before retrying any liquid, this gives the stomach a chance to rest. Remember, GO SLOW! Your child should remain on clear liquids for 12 to 24 hours before advancing diet. Observe for signs of dehydration: no tears when crying, no urine output in eight hours, dry, sticky mouth and lethargy. Call the office if vomiting lasts longer than 12 hours in infants under 6 months of age, longer than 24 hours in children 6 months to 2 years of age and longer than 48 hours in children over 2 years of age, or if with signs of dehydration.
Diarrhea is the sudden increase in the frequency and looseness of bowel movements. It is usually caused by a viral infection in the intestines. Diarrhea usually lasts from several days to a week. The main goal is to prevent dehydration due to loss of fluids. Replacement fluids include pedialyte, gatorade in children over 2 years of age, ginger ale, popsicles and jello. Avoid fruit juices as they may make diarrhea worse. The diet should be changed to foods high in fiber and starches (breads, crackers, rice, mashed potatoes, and noodles). Call the office if your child has greater than 10 watery stools in a day, if the diarrhea lasts longer than 7 days, or if you notice blood or mucus in the stool.
Among the patients that a pediatrician sees on a typical day at the office, at least one child usually presents with a red eye (pink eye). This is an infection of the clear membrane covering the white of the eye and the underside of the eyelid. The cause can be viral, bacterial or an allergic response. Bacterial conjunctivitis is the most prevalent cause of conjunctivitis. This is because when a child has an irritated eye he will rub it, thereby secondarily infecting the eye with bacteria. Children easily spread the infection through direct contact with the discharge, or through items they have touched such as towels, desks and toys. Bacterial conjunctivitis is often associated with ear infections, sinus infections and a yellow-green eye discharge. Bacterial conjunctivitis is the most common cause of pink eye in preschool children. Viral conjunctivitis is usually associated with non strep sore throats and a whitish mucousy discharge from the eye. Allergic conjunctivitis has a stringy, clear eye discharge. Treatment of bacterial conjunctivitis aims to shorten the illness, lower the recurrence rate, reduce the contagiousness of infection, eradicate the causative germ and improve quality of life for the child. This treatment usually involves the use of antibiotic eye drops. Other suggestions to decrease the spread of the illness are good hand washing, proper disposal of tissues, and using separate towels and washcloths. A concussion is a broad term and can apply to a range of injuries. It is a brain injury associated with an immediate and temporary loss of normal brain function. According to the American Academy of Pediatrics, 20% of the head injuries that occur are sports related. An even more sobering statistic is that 20% of all high school football players and 40% of all college football players will suffer a head injury at some point in their career. Concussions represent a diffuse injury to the brain. The optimal treatment is to prevent the injury in the first place. Using seat belts and wearing proper equipment while playing sports, can help avoid a concussion. The good news is the brain can repair itself. A concussion shakes up the signal pathways of the brain, so it may take a period of days or weeks for everything to return to normal. Symptoms that should raise red flags are persistent headache, nausea, vomiting or the sudden onset of weakness, seizure or abnormal pupil size. Most children make a good recovery and return to normal function. The American Academy of Pediatrics divides concussions into 3 categories: 1. MILD: confused, but not knocked out. May return to play after 20 minutes if symptoms completely clear. 2. MODERATE: confused, with memory loss. May play after one week if all symptoms clear completely. 3. SEVERE: knocked out. May play after one month if all symptoms clear. ~American Academy of Pediatrics In addition, the CDC has offered the following information regarding concussions: Signs and Symptoms Observed by Parents or Guardians
Symptoms reported by the Athlete
What you should do if you think your child has a concussion: 1. Seek medical attention right away. A health care professional will be able to decide how serious the concussion is and when it is safe for your child to return to play. 2. Keep your child out of play. The brain needs time to heal. Don't let your child return to play until a health care professional says it's OK. Children who return to play too soon - while the brain is still healing - risk a greater chance of having a second concussion. Second or later concussions can be very serious. They can cause permanent brain damage, affecting your child for a lifetime. 3. Tell your child's coach about any recent concussion. Coaches should know if your child had a recent concussion. Your child's coach may not know about about a concussion your child received in another sport or activity unless you tell the coach.
For more information visit: www.cdc.gov/ConcussioninYouthSports
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