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Roseola

Roseola or Baby measles is a viral illness that affects very young children, from 3 months to 4 years. Roseola can be traced to the human herpes virus. Roseola is contagious and spreads through sneezing, person to person contact and coughing. Often symptoms of roseola are mistaken for strep throat or ear infection.


Typical symptoms of roseola include high fever and appearance of rash. The child might suffer from upper respiratory illness such as runny nose or sore throat. The characteristic roseola rash appears after a few days of high fever. This rash resembles flat pink spots and is noticed all over the body. The high fever often brings on febrile convulsions in some children. The child will have reduced appetite and swollen lymph nodes in the neck. There might be swollen eyelids and mild diarrhea. Acetaminophen or ibuprofen is often prescribed to lower the fever. Roseola is not usually treated with any medications. The child must taken plenty of fluids and take bed rest.

Fever

Fever is an elevation of body temperature and defined as a core temperature higher than 38 C (100.4 F) in infants and higher than 38.3 C (100.9 F) in adults. Normal body temperature range is between 36 and 37.8 degree C (96.8 and 100.4 degree F). If a person has an oral temperature above 98.6 F (37 C), it is considered as fever. In some cases, there is a variation of up to 1 F (0.6 C). Fever is a symptom and not a disease. Fever, by itself is an indicator that the body is building an immune response to an infection. Most viruses and bacteria cannot survive at higher temperatures and fever is the body's fighting mechanism. Any body temperature up to 100 F is considered low grade fever. It is usually noticed along with sore throat, cough, joint pain, chills and nausea. Most fevers of this nature are self-limiting; and medication is given to provide comfort to the patient. Most of the time fever is only a symptom which can be treated symptomatically with antipyretics. Acetaminophen and ibuprofen are prescribed to control fever.


Fever results from the production of prostaglandin E2 (PGE2) in the hypothalamus due to endogenous or exogenous pyrogens. The cause is identified by physical examination and a thorough history - the onset of fever, level, duration, pattern if any and other symptoms.


Normally a person can sustain a body temperature of up to 104 degree F (40 degree C) with relative safety. But when the fever temperature rises above 104 ° it may cause cellular damage to brain, blood and internal organs. To prevent damage from high fever cooling treatments may be of help. Cold compresses, cold packs or sponge baths or ice bags /chemical cold packs are used to bring down the high fever.


Do not swathe a patient with fever in blankets but keep him comfortable. Bath in tepid water can help, but never ice cold water. The patient must be well hydrated. Some immunosuppressed or elderly patients might not exhibit a big rise in temperature in spite of a serious infection. Most often , CBC (complete blood count) is done to look for raised WBC count. Other useful indicators are urine test, gram stains and chest x-ray. If fever is also accompanied by abdominal pain, CT scan of the abdomen is suggested to look for possible appendicitis, diverticulitis and Cholecystitis.


The degree of fever elevation is not an indicator of the severity of the illness. Fever can be due to dengue, chikungunya, chicken pox, measles, malaria or other infections. Metabolic disturbances can cause body temperature to be elevated. In rare cases, fever is due to heart disease, serious illness, AIDS or cancer. Toxic shock, meningitis and peritonitis are other serious causes for high fever.

In some cases, the cause for fever is not easy to diagnose. Fever due to upper respiratory tract infection usually lasts for about 3-5 days.


Do not confuse fever with Hyperthermia, where the body temperature rises due to external sources. Here fever is also accompanied by palpitations, fainting, shivering, aches and confusion or hallucinations. When fever rises, the respiratory rate and heart rate rise. When children below 1 year suffer fever, they should be examined by a healthcare professional. Never use aspirin in children during a viral infection.



Kawasaki Disease

Kawasaki Disease or Kawasaki Syndrome typically affects children under 5 years. It is noticed more among children of Japanese and Korean origin. The rash may be worse in the groin. There is fall and rise of temperature. Symptoms of Kawasaki Disease include high fever accompanied by redness in both eyes or redness in the palms and soles. The lymph nodes in the neck may be enlarged. The fingers and toes may develop swelling and discoloration. The mouth and lips usually get severely chapped. There is a rash on the chest and stomach. The rash may be worse in the groin. There is fall and rise of temperature.


It is essential that Kawasaki disease be diagnosed and treated at an early stage to avoid complications with the heart. It can lead to an inflammation of the blood vessels of the heart (vasculitis). There can also be subsequent swelling of the heart muscles, coronary arteries and valves. Kawasaki disease goes through phases. In the initial phase, there is high fever and rashes begin to appear. Mild conjunctivitis is observed. The mouth mucous membranes are inflamed and appear bright red. In the second phase, the child experiences peeling skin on the hands and feet. There may be vomiting and diarrhea. Joint pain and swelling is noticed in the knees, hips and ankles.


Other conditions that have similar symptoms are scarlet fever, Steven Johnson syndrome and Toxic shock syndrome. Urine and blood tests are conducted to diagnose Kawasaki syndrome. Intravenous doses of gamma globulin are given to a child suffering from Kawasaki disease to boost the body's resistance to infection. Aspirin is given to relieve some of the symptoms and prevent blood clots and heart disease.

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Collection of Pages - Last revised Date: November 19, 2019