Skin rash with fever in kids. Getting rational!@
Allergy does cause an itchy swollen rash... often without fever and at times may progress to respiratory discomfort.. and hence need to be promotly understood treated and prevented. Common allergies are related to diet protein nut/egg/oats/milk/fish etc
Around winter.. three types of viral rashes are often seen. Although any viral fever including dengue fever can rash; the viral rash is often strongly described and seen with measles and chicken pox and hand foot mouth disease.
Commonest of these 3 being hand foot mouth disease HFMD... is the mildest of all and often may not need any specific measures unless has bad oral sores or complications. Its easy to know that HFMD rash is small reddish mini fluid bumps and doesnt affect trunk or back and often has a mouth sore. Fever may be short and mild. All may disappear in two weeks though can spread very fast.
Chicken pox on other hand appears more dreadful and scary rash. It has high fever at onset with trunk lesions and takes three days to spread over rest of body. Different sizes and stages of small to large fluid bumps called vesicles in different stages at a time and each bump surely scarring in a week; and no new bumps beyond ten days since onset is most likely chicken pox. It can cause complications like acute pneumonia.
Rash of HFMD is discrete-small and in measles bumps are very small size and in 'chicken pox and measles' heavily spread all over body.
Measles rash is more common in kids who have skipped measles vaccine of 10 month age. Rash is fine sand like but red; starting in neck with high fever and spreading all over body in two days. Fever settles by three days and rash in a week without any scar. If u see WOUNDS or scar.. surely its not measles. Measles causes fall in immunity and has serious complications like pneumonia or TB to follow over a month.
Its important not to panic; but understand the disease course and visit a doctor earliest. Read danger signs and basic care in viral fever at kondekar.com
Remember if child refuses feed even twice or prefers to lie down more than six hours without sleep.. it may be a sign for hospital based observation.
There are tens of viruses and bacteria that cause a large variety of rashes. This is just an awareness basic.
what is a concern? worry? seriousness? emergency? super emergency? in medical practice.
A parent should address the complaints, and also a doctor should infer and explain the complaints under following aspects:
concern, worry, seriousness, energency and super emergency (life/ability risk)
Concern is something that is unusual for the patient as interpreted by a patient or noted by a doctor.
Worry is something that is a persistant concern.
Persistant Worry makes it serious complaint, there is a chance of disability or emergency.
Emergency is a matter of seriousness, that needs to be tackled promptly and if neglected, may risk life or ability (super emergency).
Super Emergency (life/disability risk), is a situation of extreme emergency where even seconds delay may have serious sequalae in the form of morbidity/disability or mortality.
The terms may sound difficult to understand.
occasional fever is a concern.
repeated fever is a worry.
daily repeated fever is seriousness.
high fever can be an emergency.
high fever with seizure or any danger signs can be a life/ability risk so super emergency..
taken as it is from
Recently Dengue fever cases are on rise with decline in malaria cases in Mumbai.
It can present in various different forms with different patterns of fever or no fever. The care in Dengue fever is like that in any viral fever as mentioned below but in addition dengue can at times gets serious and life threatening and early signs that may warrant extra care/ monitoring or hospitalisation are:
1. drop in platelet count or total cell count
2.swollen face or limbs/hands/feet or distended tummy all may suggest fluid retention
3. reduced urine, low blood pressure or giddiness or feeling for lying down in bed than sitting or doing normal work
4.any rash/bruses or bleeding or similar manifestation
Tests that may make a confirmation are NS1 antigen test fro first 3-4 days of fever , then IgM and IgG tests for Dengue in subsequent days.
Tests are less important than clinical monitoring.Real risk may start when fever disappears and platelets start falling down.
Many viruses cause similar picture and are called dengue like illness when tests are negative. once first weeks symptom phase is passed, relatively there little or no risk due to dengue. As it spreads by mosquito bite, a simple trick of using body creams of mosquito repellant like say odomos will help prevent mosquito bites and spread of dengue from person to person in family and kids.
viral fevers - If the fever disappears from the day you visited ... most likely the sufferings were a part of viral fever only.
It does not mean that viral fevers do not last more than 3-5 days. But often by the time you decide to watch fever at home and visit a doctor for a fever of three days... its almost always settling if the fever were of viral types. If its not... may be its not a viral fever.
A viral fever may cause other symptoms or weakness that may necessitate a doctor visit even though fever is settled. In bacterial fevers often the fever doesnot settle unless specific therapy initiated.
All fevers do cause reduced intake of solids and eventually making one feel weak.. thirsty and lethargic. Its important to maintain good water intake during all patterns of illnesses observed at home. I recommend half a cup of water as medicine every hour at least 8-10 times a day for say a five year kid to maintain good hydration and urine. "Do offer other diet and feeds but dont force solids" out of child's will if he can't swallow say due to throat infection or cant digest.. say due to gut infection. Its not exactly a loss of appetite but inability to accept feeds in gut. Often such reduced intake persists for a week after any disease and donot need appetite drugs but good control of disease and enough water. In any disease.. care to be taken to have enough water or liquid intake ao that child will pass urine at leat two times in 12 hours (its never a medical emergency if a child doesnt pass stools for 2 days unless child has very bad vomit/colicky pain in abdomen)... if not... your doctor will be worried that the kid is likely to require hospital admission mainly to ensure superwised intake or iv fluids and also simultaneous disease control.
Child Specialist dr Kondekar shared a link. Posted by Santosh Kondekar · 15 minutes agoIn a case of loose motions, a doctor will be more interested in how much and how often urine child has passed in last 12 hours? and whether the child is feeding normally or his activity affected? "irritability and thirst" are one of the early signs of dehydration which parents may note, well before tissue dehydration detected by parents.read more about loose motions at http://kondekar.weebly.com/diarrhea-in-children.html
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