Cause
Tuberculosis (TB) is primarily caused by the bacterium Mycobacterium tuberculosis, but other related mycobacteria may cause similar symptoms.
Symptoms
Initially there are no signs of disease, except a positive tuberculin skin test, which indicates the child has been infected. The infection usually resolves on its own as the child develops immunity over a 6- to 10-week period. But in some cases tuberculosis can progress and spread throughout the lungs and to other organs. Symptoms include fever, night sweats,weight loss, fatigue, loss of appetite, and cough, sometimes with blood-tinged mucus. In other cases, more often in older children and adults, the infection remains dormant, sometimes for years, and then is reactivated when the immune system is weakened.
How It Spreads
TB is spread by inhaling airborne fluid droplets from an infected person who sneezes or coughs. Young children with TB rarely infect older children or adults.
Incubation Period
The time between initial infection and apparent disease is variable; early signs often occur within two to six months of infection with the germ, but they may not show up for years.
How Long Symptoms Last
Tuberculosis is a chronic disease that can persist for years if not treated.
When to Call Your Child’s Doctor
Call your child’s doctor if your child has a persistent fever or cough or if your child has come in contact with someone who is known to have or who is suspected to have TB.
How the Diagnosis Is Made
A skin test (PPD), involving a small injection of test material under the skin, will tell if the child has been exposed to tuberculosis. If positive, the doctor may order a chest X-ray and examination of stomach fluid to look for the bacteria in swallowed mucus coughed up from the lungs.
Treatment
Generally, children with a positive skin test but no symptoms will be given one drug. Those with active infection are given several, usually over a period of months. These may include isoniazid, rifampin, pyrazinamide, streptomycin, ethambutol, and others.
Home Treatment
A child with TB needs adequate rest and nutrition. You need to make sure your child takes his medications as prescribed to ensure that the bacteria are killed.
Prevention
Prevention depends on avoiding contact with those (usually adults) who have active disease, testing those who are at high risk for the disease, and promptly and adequately treating those with active infections to control spread to others. A vaccine called BCG can prevent TB in some situations, but it is not routinely given in this country due to the low likelihood of contracting the disease. It is recommended for children who are at high risk of long-term, close exposure to untreated or ineffectively treated adults.
Contagious Periods
Someone infected with tuberculosis is very contagious to others because tuberculosis is spread through the air, by coughing or sneezing. TB bacteria can remain airborne for a period of time, long enough for an uninfected person to breathe them in. Anyone with active TB should not be around anyone with immune system problems such as someone with HIV or someone who is receiving chemotherapy.
Complications
TB can spread to other organs, such as the kidney, liver, spleen, and brain, causing severe illness and requiring hospitalization. Untreated, TB can be fatal.
Tetanus (Lockjaw)
Cause
Tetanus is caused by a toxin released into the nerves and muscles by the bacterium Clostridium tetani, which is found in soil, dust, and the feces of some animals. The disease occurs very rarely in the United States, in part due to the availability and routine use of the tetanus vaccine.
Symptoms
It usually begins with muscle spasms in the jaw, along with headache, restlessness, and irritability, followed by difficulty chewing and swallowing and stiffness or pain in the muscles of the neck, shoulders, or back. The muscles of the face can lock into a characteristic smile with arched eyebrows. There may be a fever and chills. Spasms spread to muscles in the stomach, back, hip, and thigh muscles.
How It Spreads
Most cases in the United States develop from a puncture wound or cut from a dirty object such as a nail, splinter, or fragment of glass. Neonatal tetanus occurs after a baby is delivered in unsanitary conditions, especially if the umbilical cord cut is contaminated with the bacteria and the mother has not been immunized against tetanus.
Incubation Period
The incubation period is typically 2 to 14 days, but it can be as long as months after the injury. Symptoms of neonatal tetanus typically begin 3 to 12 days after birth.
How Long Symptoms Last
Recovery usually takes at least four to six weeks.
When to Call Your Child’s Doctor
Call your child’s doctor if your child gets a wound, especially if it is a puncture wound or an animal bite, and she has not been immunized against tetanus or you are unsure when she got her last tetanus booster; if your child develops any of the symptoms of tetanus; or if you are pregnant and unsure about your tetanus immunization status.
How the Diagnosis Is Made
The diagnosis is usually made based on the history of symptoms and the doctor’s physical examination of the child.
Treatment
Tetanus is treated in the hospital, usually in an intensive care unit. The child receives antibiotics to kill the bacteria and an antitoxin to neutralize the toxin. Medications are given to control muscle spasms and to stop abnormal nerve activity that can cause disturbances in heartbeat, blood pressure, and body temperature.
Prevention
Tetanus can be prevented by receiving the recommended routine immunizations with tetanus vaccine—usually as part of the DTaP (diphtheria-tetanuspertussis) vaccine—at 2, 4, 6, and 15 to 18 months and again at 4 to 6 years. Boosters should be given thereafter at 10-year intervals. Although cleaning a dirt- or soilcontaminated wound is not a substitute for immunization, be sure to clean all wounds.
Contagious Periods
The disease is not a contagious one.
Complications
Death occurs in 5 to 35 percent of cases. With intensive care treatment, fewer than 10 percent of infants with neonatal tetanus will die; without it, more than 75 percent die. In some cases, children, especially infants, will suffer brain injury, resulting in cerebral palsy, mental retardation, or behavioral difficulties.
Tetanus is caused by a toxin released into the nerves and muscles by the bacterium Clostridium tetani, which is found in soil, dust, and the feces of some animals. The disease occurs very rarely in the United States, in part due to the availability and routine use of the tetanus vaccine.
Symptoms
It usually begins with muscle spasms in the jaw, along with headache, restlessness, and irritability, followed by difficulty chewing and swallowing and stiffness or pain in the muscles of the neck, shoulders, or back. The muscles of the face can lock into a characteristic smile with arched eyebrows. There may be a fever and chills. Spasms spread to muscles in the stomach, back, hip, and thigh muscles.
How It Spreads
Most cases in the United States develop from a puncture wound or cut from a dirty object such as a nail, splinter, or fragment of glass. Neonatal tetanus occurs after a baby is delivered in unsanitary conditions, especially if the umbilical cord cut is contaminated with the bacteria and the mother has not been immunized against tetanus.
Incubation Period
The incubation period is typically 2 to 14 days, but it can be as long as months after the injury. Symptoms of neonatal tetanus typically begin 3 to 12 days after birth.
How Long Symptoms Last
Recovery usually takes at least four to six weeks.
When to Call Your Child’s Doctor
Call your child’s doctor if your child gets a wound, especially if it is a puncture wound or an animal bite, and she has not been immunized against tetanus or you are unsure when she got her last tetanus booster; if your child develops any of the symptoms of tetanus; or if you are pregnant and unsure about your tetanus immunization status.
How the Diagnosis Is Made
The diagnosis is usually made based on the history of symptoms and the doctor’s physical examination of the child.
Treatment
Tetanus is treated in the hospital, usually in an intensive care unit. The child receives antibiotics to kill the bacteria and an antitoxin to neutralize the toxin. Medications are given to control muscle spasms and to stop abnormal nerve activity that can cause disturbances in heartbeat, blood pressure, and body temperature.
Prevention
Tetanus can be prevented by receiving the recommended routine immunizations with tetanus vaccine—usually as part of the DTaP (diphtheria-tetanuspertussis) vaccine—at 2, 4, 6, and 15 to 18 months and again at 4 to 6 years. Boosters should be given thereafter at 10-year intervals. Although cleaning a dirt- or soilcontaminated wound is not a substitute for immunization, be sure to clean all wounds.
Contagious Periods
The disease is not a contagious one.
Complications
Death occurs in 5 to 35 percent of cases. With intensive care treatment, fewer than 10 percent of infants with neonatal tetanus will die; without it, more than 75 percent die. In some cases, children, especially infants, will suffer brain injury, resulting in cerebral palsy, mental retardation, or behavioral difficulties.
Sinusitis
Cause
Viruses that cause colds also can cause inflammation of the sinuses, the air spaces found in the facial bones around the nose. Acute bacterial infections of the sinuses around the nose are caused by the same germs that cause middle ear infections: Streptococcus pneumoniae, Moraxella catarrhalis, and Hemophilus influenzae. In chronic sinusitis, Staphylococcus aureus or multiple types of bacteria may be involved.
Symptoms
Cough and nasal discharge are the most common symptoms of acute sinusitis. The cough occurs during daytime and often is worse when lying down for naps or at bedtime. Nasal discharge may be clear or cloudy. The child may have a sore throat as a result of postnasal drip, and the child may sniff, snort, or snore to clear the drainage. Viral upper respiratory infections usually clear up within 10 to 14 days. If symptoms persist without improvement for more than 10 to 14 days, bacterial sinusitis should be suspected. A more severe but less common form of sinusitis can occur in which the child develops a fever higher than 101 degrees Fahrenheit, a cloudy nasal discharge, headache, and eye swelling. In chronic sinusitis, cough, nasal discharge, and bad breath last for more than 30 days.
How It Spreads
Bacteria and viruses are passed via throat and nose droplets.
Incubation Period
The incubation period varies.
How Long Symptoms Last
Viral infections resolve on their own within 10 to 14 days. With bacterial infections, once the child begins antibiotics, symptoms will usually subside within several days, but it may take several weeks for symptoms to completely disappear.
When to Call Your Child’s Doctor
Call your child’s doctor if your child has a “cold” that lasts more than 10 to 14 days, if there are any symptoms of “allergies” that don’t clear up with the usual allergy treatments, if she complains about a headache or pressure behind her cheeks or forehead, or if she has facial swelling.
How the Diagnosis Is Made
The doctor will ask about symptoms, how long your child has had them, and where the pain and pressure is to try to distinguish whether the symptoms are caused by nasal allergies or viral or bacterial infection of the sinuses. X-rays or other imaging studies are sometimes used to diagnose sinusitis.
Treatment
For viral infections, there is no specific treatment. For bacterial infections, antibiotics are given for 14 to 21 days. Decongestants may improve symptoms but do not clear the infection faster. Antihistamines are not helpful and may interfere with sinus drainage because they may cause thickening of secretions.
Home Treatment
Acetaminophen, ibuprofen, and/or warm compresses may help reduce facial pain. Do not use aspirin because of the rare but potentially fatal Reye syndrome. If the child is old enough, saline nose drops can be used to help promote drainage of secretions and reduce swelling. A cool-mist vaporizer can help keep secretions moist so that the sinuses can drain more easily.
Prevention
Encourage your child to cover her nose and mouth when she coughs or sneezes and not to share food or utensils. In the winter months, use a humidifier to keep home humidity at 45 to 50 percent; this will help make sinuses less of a target for infections. Avoid exposing your child to cigarette smoke—this can irritate mucous membranes and set the stage for sinusitis.
Complications
In rare cases, the infection can spread out of the sinuses into other parts of the head, invading the bones (osteomyelitis) of the skull or spreading toward the eyes, causing an abscess (collection of pus) in or near the eye (orbital cellulitis). The infection can also invade the membranes surrounding the brain causing meningitis, which can be life-threatening.
Viruses that cause colds also can cause inflammation of the sinuses, the air spaces found in the facial bones around the nose. Acute bacterial infections of the sinuses around the nose are caused by the same germs that cause middle ear infections: Streptococcus pneumoniae, Moraxella catarrhalis, and Hemophilus influenzae. In chronic sinusitis, Staphylococcus aureus or multiple types of bacteria may be involved.
Symptoms
Cough and nasal discharge are the most common symptoms of acute sinusitis. The cough occurs during daytime and often is worse when lying down for naps or at bedtime. Nasal discharge may be clear or cloudy. The child may have a sore throat as a result of postnasal drip, and the child may sniff, snort, or snore to clear the drainage. Viral upper respiratory infections usually clear up within 10 to 14 days. If symptoms persist without improvement for more than 10 to 14 days, bacterial sinusitis should be suspected. A more severe but less common form of sinusitis can occur in which the child develops a fever higher than 101 degrees Fahrenheit, a cloudy nasal discharge, headache, and eye swelling. In chronic sinusitis, cough, nasal discharge, and bad breath last for more than 30 days.
How It Spreads
Bacteria and viruses are passed via throat and nose droplets.
Incubation Period
The incubation period varies.
How Long Symptoms Last
Viral infections resolve on their own within 10 to 14 days. With bacterial infections, once the child begins antibiotics, symptoms will usually subside within several days, but it may take several weeks for symptoms to completely disappear.
When to Call Your Child’s Doctor
Call your child’s doctor if your child has a “cold” that lasts more than 10 to 14 days, if there are any symptoms of “allergies” that don’t clear up with the usual allergy treatments, if she complains about a headache or pressure behind her cheeks or forehead, or if she has facial swelling.
How the Diagnosis Is Made
The doctor will ask about symptoms, how long your child has had them, and where the pain and pressure is to try to distinguish whether the symptoms are caused by nasal allergies or viral or bacterial infection of the sinuses. X-rays or other imaging studies are sometimes used to diagnose sinusitis.
Treatment
For viral infections, there is no specific treatment. For bacterial infections, antibiotics are given for 14 to 21 days. Decongestants may improve symptoms but do not clear the infection faster. Antihistamines are not helpful and may interfere with sinus drainage because they may cause thickening of secretions.
Home Treatment
Acetaminophen, ibuprofen, and/or warm compresses may help reduce facial pain. Do not use aspirin because of the rare but potentially fatal Reye syndrome. If the child is old enough, saline nose drops can be used to help promote drainage of secretions and reduce swelling. A cool-mist vaporizer can help keep secretions moist so that the sinuses can drain more easily.
Prevention
Encourage your child to cover her nose and mouth when she coughs or sneezes and not to share food or utensils. In the winter months, use a humidifier to keep home humidity at 45 to 50 percent; this will help make sinuses less of a target for infections. Avoid exposing your child to cigarette smoke—this can irritate mucous membranes and set the stage for sinusitis.
Complications
In rare cases, the infection can spread out of the sinuses into other parts of the head, invading the bones (osteomyelitis) of the skull or spreading toward the eyes, causing an abscess (collection of pus) in or near the eye (orbital cellulitis). The infection can also invade the membranes surrounding the brain causing meningitis, which can be life-threatening.
Rabies
Cause
The rabies virus causes an infection of the nervous system. It is usually transmitted by an animal bite. Human cases are extremely rare in the United States; most years, there are no reported cases.
Symptoms
The first stage usually lasts 2 to 10 days. Symptoms include fever, headache, muscle aches, loss of appetite, nausea, vomiting, sore throat, cough, and fatigue. There may be a tingling or twitching sensation around the area of the bite. The second stage, lasting 2 to 21 days, begins with a fever as high as 105 degrees Fahrenheit and any of the following: irritability; excessive movement or agitation; confusion; hallucinations; aggressiveness; muscle spasm; seizures; weakness or paralysis; extreme sensitivity to light, sounds, or touch; increased saliva or tears; and an inability to speak as vocal cords become paralyzed. In the last phases, there may be double vision, abnormal movements of the muscles that control breathing, and difficulty swallowing. Swallowing problems and increased saliva lead to foaming at the mouth.
How It Spreads
The rabies virus is carried in the saliva of infected animals and is usually transmitted to humans through an animal bite. In rare cases, it can be spread when an infected animal’s saliva touches mucous membranes, like the mouth or eyelids, or comes in contact with a cut or broken skin. In the United States the most common carriers are bats, raccoons, skunks, and foxes; cases have been reported with wolves, coyotes, bobcats, and ferrets as carriers. Animals not expected to carry rabies include small rodents, rabbits, and hares. In Central and South America, dogs are the main carriers.
Incubation Period
The incubation period is usually 20 to 180 days, with the peak at 30 to 60 days.
How Long Symptoms Last
Recovery is rare in humans who have developed symptoms.
When to Call Your Child’s Doctor
Call your child’s doctor immediately if your child has any signs or symptoms of rabies, especially if he has been bitten recently by an animal. Call the doctor as well if your child has been bitten by an animal or has been exposed to a cat, dog, bat, or other animal that might have rabies. Also, call if you are planning a trip abroad where you might come in contact with infected animals.
How the Diagnosis Is Made
The doctor will ask about recent animal exposure and look for symptoms.
Treatment
There is no specific effective treatment once symptoms have developed. The person receives supportive care in an intensive care setting. Only a few individuals who have developed the disease have survived.
Prevention
If your child is bitten by an animal, wash the area of the bite thoroughly with soap and water for 10 minutes and call your child’s doctor, who will clean the wound thoroughly and check to make sure tetanus shots are up to date. You may also call the local animal control authorities to help find the animal that caused the bite. If the doctor decides to treat your child to prevent rabies, the treatment will involve shots of human diploid cell vaccine and human rabies immune globulin into a muscle, which should begin the day the child was bitten to be most effective. Part of human rabies immune globulin is usually injected near the bite area. Warn your child not to touch or feed stray animals, even dogs or cats. Report any stray animals to local health or animal control authorities, especially if they are acting strangely.
The rabies virus causes an infection of the nervous system. It is usually transmitted by an animal bite. Human cases are extremely rare in the United States; most years, there are no reported cases.
Symptoms
The first stage usually lasts 2 to 10 days. Symptoms include fever, headache, muscle aches, loss of appetite, nausea, vomiting, sore throat, cough, and fatigue. There may be a tingling or twitching sensation around the area of the bite. The second stage, lasting 2 to 21 days, begins with a fever as high as 105 degrees Fahrenheit and any of the following: irritability; excessive movement or agitation; confusion; hallucinations; aggressiveness; muscle spasm; seizures; weakness or paralysis; extreme sensitivity to light, sounds, or touch; increased saliva or tears; and an inability to speak as vocal cords become paralyzed. In the last phases, there may be double vision, abnormal movements of the muscles that control breathing, and difficulty swallowing. Swallowing problems and increased saliva lead to foaming at the mouth.
How It Spreads
The rabies virus is carried in the saliva of infected animals and is usually transmitted to humans through an animal bite. In rare cases, it can be spread when an infected animal’s saliva touches mucous membranes, like the mouth or eyelids, or comes in contact with a cut or broken skin. In the United States the most common carriers are bats, raccoons, skunks, and foxes; cases have been reported with wolves, coyotes, bobcats, and ferrets as carriers. Animals not expected to carry rabies include small rodents, rabbits, and hares. In Central and South America, dogs are the main carriers.
Incubation Period
The incubation period is usually 20 to 180 days, with the peak at 30 to 60 days.
How Long Symptoms Last
Recovery is rare in humans who have developed symptoms.
When to Call Your Child’s Doctor
Call your child’s doctor immediately if your child has any signs or symptoms of rabies, especially if he has been bitten recently by an animal. Call the doctor as well if your child has been bitten by an animal or has been exposed to a cat, dog, bat, or other animal that might have rabies. Also, call if you are planning a trip abroad where you might come in contact with infected animals.
How the Diagnosis Is Made
The doctor will ask about recent animal exposure and look for symptoms.
Treatment
There is no specific effective treatment once symptoms have developed. The person receives supportive care in an intensive care setting. Only a few individuals who have developed the disease have survived.
Prevention
If your child is bitten by an animal, wash the area of the bite thoroughly with soap and water for 10 minutes and call your child’s doctor, who will clean the wound thoroughly and check to make sure tetanus shots are up to date. You may also call the local animal control authorities to help find the animal that caused the bite. If the doctor decides to treat your child to prevent rabies, the treatment will involve shots of human diploid cell vaccine and human rabies immune globulin into a muscle, which should begin the day the child was bitten to be most effective. Part of human rabies immune globulin is usually injected near the bite area. Warn your child not to touch or feed stray animals, even dogs or cats. Report any stray animals to local health or animal control authorities, especially if they are acting strangely.
Pneumonia
Cause
Pneumonia is a general term referring to an infection of the lungs caused by viruses, bacteria, fungi, and parasites. In otherwise healthy children, viral pneumonia is most common. Viruses causing pneumonia include respiratory syncytial virus (RSV), parainfluenza, influenza, and adenoviruses. Among bacteria, Streptococcus pneumoniae, Streptococcus pyogenes (group A Streptococcus), and Staphylococcus aureus are the most common causes. Since the introduction of the Hib vaccine, Hemophilus influenzae type B is less often a cause.
The sexually transmitted bacterium Chlamydia trachomatis can be passed on from the mother to the baby during delivery, leading to pneumonia. The microbe Mycoplasma pneumoniae also accounts for many cases the ribs and the nostrils flare; vomiting; chest pain; abdominal pain; decreased activity; loss of appetite or poor feeding; and bluish lips, tongue, and fingernails.
How It Spreads
The viruses and bacteria are usually spread by nose and throat droplets passed along by coughing, sneezing, or coming in contact with the germ on utensils or used tissues. Although the person with the germ may not have pneumonia, the germ can cause pneumonia when passed on to the child.
Incubation Period
The incubation period depends on the organism. Incubation for RSV is four to six days; influenza is one to four days; mycoplasma is one to three weeks.
How Long Symptoms Last
With antibiotics, symptoms of most bacterial pneumonia will subside within the first 24 to 48 hours, although it may take several weeks before the lungs return to normal. Symptoms of viral pneumonia may last several days longer. With antibiotics, symptoms of mycoplasma pneumonia will improve over four to five days.
When to Call Your Child’s Doctor
Call your child’s doctor if your child has any signs or symptoms of pneumonia, especially if he is breathing faster than usual, has a cough that is getting worse, has a fever of 101 to 102 degrees Fahrenheit or higher, or has signs of respiratory distress. Take your child to the emergency room if he is making a grunting sound when breathing; is struggling or gasping to breathe; has a bluish color of the lips, tongue, and fingernails; is lethargic or unresponsive; or pauses in breathing for longer than 15 seconds. Call your child’s doctor if your child is being treated forpneumonia and symptoms have not improved within 48 to 72 hours.
How the Diagnosis Is Made
Your child’s doctor will ask about symptoms and listen to your child’s chest with a stethoscope to hear where and how breathing is impaired; he or she may order a chest X-ray. The doctor may also take a blood test and a sample of mucus produced by coughing to see what organism is causing the infection.
Treatment
In severe cases the child may be hospitalized. Bacterial or mycoplasma pneumoniais treated with antibiotics; the type used depends on the germ. Antibiotics are ineffective against viral pneumonia, and most patients recover with supportive care such as fluids, rest, and, if necessary, extra oxygen. If diagnosed within 48 hours of the infection, viral pneumonia may be treated in some cases with antiviral medication to reduce symptoms.
Home Treatment
Use a cool-mist humidifier to increase air moisture. Encourage your child to drink fluids, especially with a fever. Ask your child’s doctor before using cough suppressant medications because they can interfere with clearing mucus from the lungs, and this may be harmful in some cases of pneumonia.
Prevention
Children younger than two years, those with weakened immune systems, and other high-risk children should be vaccinated against Streptococcus pneumoniae. The influenza vaccine is also recommended for high-risk children, including those with chronic lung or heart conditions that can make them more likely to develop pneumonia if they are infected with the virus.
Pertussis (whooping cough), which can also lead to pneumonia, is the “P” part of the routine DTaP vaccine. The Hemophilus influenzae type B vaccine, given to infants beginning at two months, is 70 to 100 percent effective in protecting against infection with this germ. If someone in your house has pneumonia or a respiratory infection that could lead to pneumonia, keep your child away and practice good hygiene, keeping eating utensils separate and washing hands frequently.
Contagious Periods
The contagious period depends on the organism.
Complications
The mortality rate for children with bacterial pneumonia is less than 1 percent with antibiotic treatment. Almost all children with viral pneumonia recover without treatment, although RSV infections can be life-threatening, especially in infants younger than six weeks or those with heart or lung problems or a weakened immune system.
Pneumonia is a general term referring to an infection of the lungs caused by viruses, bacteria, fungi, and parasites. In otherwise healthy children, viral pneumonia is most common. Viruses causing pneumonia include respiratory syncytial virus (RSV), parainfluenza, influenza, and adenoviruses. Among bacteria, Streptococcus pneumoniae, Streptococcus pyogenes (group A Streptococcus), and Staphylococcus aureus are the most common causes. Since the introduction of the Hib vaccine, Hemophilus influenzae type B is less often a cause.
The sexually transmitted bacterium Chlamydia trachomatis can be passed on from the mother to the baby during delivery, leading to pneumonia. The microbe Mycoplasma pneumoniae also accounts for many cases the ribs and the nostrils flare; vomiting; chest pain; abdominal pain; decreased activity; loss of appetite or poor feeding; and bluish lips, tongue, and fingernails.
How It Spreads
The viruses and bacteria are usually spread by nose and throat droplets passed along by coughing, sneezing, or coming in contact with the germ on utensils or used tissues. Although the person with the germ may not have pneumonia, the germ can cause pneumonia when passed on to the child.
Incubation Period
The incubation period depends on the organism. Incubation for RSV is four to six days; influenza is one to four days; mycoplasma is one to three weeks.
How Long Symptoms Last
With antibiotics, symptoms of most bacterial pneumonia will subside within the first 24 to 48 hours, although it may take several weeks before the lungs return to normal. Symptoms of viral pneumonia may last several days longer. With antibiotics, symptoms of mycoplasma pneumonia will improve over four to five days.
When to Call Your Child’s Doctor
Call your child’s doctor if your child has any signs or symptoms of pneumonia, especially if he is breathing faster than usual, has a cough that is getting worse, has a fever of 101 to 102 degrees Fahrenheit or higher, or has signs of respiratory distress. Take your child to the emergency room if he is making a grunting sound when breathing; is struggling or gasping to breathe; has a bluish color of the lips, tongue, and fingernails; is lethargic or unresponsive; or pauses in breathing for longer than 15 seconds. Call your child’s doctor if your child is being treated forpneumonia and symptoms have not improved within 48 to 72 hours.
How the Diagnosis Is Made
Your child’s doctor will ask about symptoms and listen to your child’s chest with a stethoscope to hear where and how breathing is impaired; he or she may order a chest X-ray. The doctor may also take a blood test and a sample of mucus produced by coughing to see what organism is causing the infection.
Treatment
In severe cases the child may be hospitalized. Bacterial or mycoplasma pneumoniais treated with antibiotics; the type used depends on the germ. Antibiotics are ineffective against viral pneumonia, and most patients recover with supportive care such as fluids, rest, and, if necessary, extra oxygen. If diagnosed within 48 hours of the infection, viral pneumonia may be treated in some cases with antiviral medication to reduce symptoms.
Home Treatment
Use a cool-mist humidifier to increase air moisture. Encourage your child to drink fluids, especially with a fever. Ask your child’s doctor before using cough suppressant medications because they can interfere with clearing mucus from the lungs, and this may be harmful in some cases of pneumonia.
Prevention
Children younger than two years, those with weakened immune systems, and other high-risk children should be vaccinated against Streptococcus pneumoniae. The influenza vaccine is also recommended for high-risk children, including those with chronic lung or heart conditions that can make them more likely to develop pneumonia if they are infected with the virus.
Pertussis (whooping cough), which can also lead to pneumonia, is the “P” part of the routine DTaP vaccine. The Hemophilus influenzae type B vaccine, given to infants beginning at two months, is 70 to 100 percent effective in protecting against infection with this germ. If someone in your house has pneumonia or a respiratory infection that could lead to pneumonia, keep your child away and practice good hygiene, keeping eating utensils separate and washing hands frequently.
Contagious Periods
The contagious period depends on the organism.
Complications
The mortality rate for children with bacterial pneumonia is less than 1 percent with antibiotic treatment. Almost all children with viral pneumonia recover without treatment, although RSV infections can be life-threatening, especially in infants younger than six weeks or those with heart or lung problems or a weakened immune system.
Meningitis
Cause
An inflammation of the meninges, the membrane covering the brain and spinal cord, meningitis can be caused by bacteria, viruses, fungi, or parasites that enter into the cerebrospinal fluid from the blood. Streptococcus pneumoniae, Neisseria meningitidis, and Hemophilus influenzae type B are the most common bacteria causing the infection in children. Enteroviruses are the most frequent viral cause. Bacterial infections are generally more serious than viral defects of the meninges and are potentially life-threatening.
Symptoms
Symptoms may include fever, severe headache, stiff neck, nausea, vomiting, irritability, sensitivity to light, seizure, rash, bulging fontanel (soft spot on top of the head) in infant, rash or bruise marks, confusion, or coma (unconsciousness).
How It Spreads
The bacteria and viruses are usually spread by contact with infected feces or nose and throat drops. Typically, the infection begins in the respiratory system, but it can begin in other parts of the body, including the heart valves, bones, ears, nose, or teeth.
Incubation Period
This varies with the organism. For enteroviruses, the incubation period is 3 to 6 days; other viruses may range from 4 to 21 days. Once the infection has entered the spinal fluid, symptoms usually occur rapidly.
How Long Symptoms Last
The duration of symptoms varies according to cause. Once treatment begins, fever associated with bacterial infection usually resolves in 5 to 7 days, but fever longer than 10 days occurs in 10 percent of children. Viral infections usually are milder and symptoms last several days.
When to Call Your Child’s Doctor
Call your child’s doctor immediately if your child has any of these symptoms: persistent vomiting, severe headache, stiff neck, lethargy or confusion, rash, or fever. In infants, also look for a bulging soft spot, irritability, poor feeding, and lethargy. If your child has had contact with someone with meningitis, consult your child’s doctor.
How the Diagnosis Is Made
A lumbar puncture, or spinal tap, is performed to examine the spinal fluid. Blood and urine tests may also be done.
Treatment
Often antibiotics and intravenous fluids are given before the organism is identified, and the child is placed in isolation in the hospital. If the cause is a virus, the antibiotics will be stopped and the child may be given a pain reliever such as acetaminophen and, in some cases, intravenous fluids. If the cause is bacterial, antibiotics will be continued for up to several weeks; corticosteroids to relieve inflammation may also be given.
Prevention
The Hemophilus influenzae type B vaccine, given to infants beginning at two months, is 70 to 100 percent effective in protecting against this cause of meningitis. Children younger than two years and children with weakened immune systems should be vaccinated against Streptococcus pneumoniae. For children exposed to meningitis caused by certain bacteria, the doctor may prescribe the antibiotic rifampin to prevent infection.
Complications
Most children completely recover from viral meningitis. Severe cases can result in seizures and intellectual, motor, hearing, visual, and psychiatric problems. In bacterial infections, the mortality rate in infants (after the newborn period) and children is 1 to 8 percent. Significant neurological and developmental problems occur in 10 to 20 percent of patients surviving the infection, including hearing loss, mental retardation, seizures, delay in speaking, visual impairment, and behavioral problems.
An inflammation of the meninges, the membrane covering the brain and spinal cord, meningitis can be caused by bacteria, viruses, fungi, or parasites that enter into the cerebrospinal fluid from the blood. Streptococcus pneumoniae, Neisseria meningitidis, and Hemophilus influenzae type B are the most common bacteria causing the infection in children. Enteroviruses are the most frequent viral cause. Bacterial infections are generally more serious than viral defects of the meninges and are potentially life-threatening.
Symptoms
Symptoms may include fever, severe headache, stiff neck, nausea, vomiting, irritability, sensitivity to light, seizure, rash, bulging fontanel (soft spot on top of the head) in infant, rash or bruise marks, confusion, or coma (unconsciousness).
How It Spreads
The bacteria and viruses are usually spread by contact with infected feces or nose and throat drops. Typically, the infection begins in the respiratory system, but it can begin in other parts of the body, including the heart valves, bones, ears, nose, or teeth.
Incubation Period
This varies with the organism. For enteroviruses, the incubation period is 3 to 6 days; other viruses may range from 4 to 21 days. Once the infection has entered the spinal fluid, symptoms usually occur rapidly.
How Long Symptoms Last
The duration of symptoms varies according to cause. Once treatment begins, fever associated with bacterial infection usually resolves in 5 to 7 days, but fever longer than 10 days occurs in 10 percent of children. Viral infections usually are milder and symptoms last several days.
When to Call Your Child’s Doctor
Call your child’s doctor immediately if your child has any of these symptoms: persistent vomiting, severe headache, stiff neck, lethargy or confusion, rash, or fever. In infants, also look for a bulging soft spot, irritability, poor feeding, and lethargy. If your child has had contact with someone with meningitis, consult your child’s doctor.
How the Diagnosis Is Made
A lumbar puncture, or spinal tap, is performed to examine the spinal fluid. Blood and urine tests may also be done.
Treatment
Often antibiotics and intravenous fluids are given before the organism is identified, and the child is placed in isolation in the hospital. If the cause is a virus, the antibiotics will be stopped and the child may be given a pain reliever such as acetaminophen and, in some cases, intravenous fluids. If the cause is bacterial, antibiotics will be continued for up to several weeks; corticosteroids to relieve inflammation may also be given.
Prevention
The Hemophilus influenzae type B vaccine, given to infants beginning at two months, is 70 to 100 percent effective in protecting against this cause of meningitis. Children younger than two years and children with weakened immune systems should be vaccinated against Streptococcus pneumoniae. For children exposed to meningitis caused by certain bacteria, the doctor may prescribe the antibiotic rifampin to prevent infection.
Complications
Most children completely recover from viral meningitis. Severe cases can result in seizures and intellectual, motor, hearing, visual, and psychiatric problems. In bacterial infections, the mortality rate in infants (after the newborn period) and children is 1 to 8 percent. Significant neurological and developmental problems occur in 10 to 20 percent of patients surviving the infection, including hearing loss, mental retardation, seizures, delay in speaking, visual impairment, and behavioral problems.
Influenza (Flu)
Cause
There are three types of influenza virus: Type A is usually responsible for large epidemics and is constantly changing with new strains appearing. Type B causes smaller, more localized outbreaks. Type C is less common and usually causes mild illness. Flu epidemics usually occur between November and March.
Symptoms
Flu symptoms may be similar to those of the common cold, but they tend to develop quickly and are more severe. They can include fever (often sudden and high), chills, headache, muscle aches, dizziness, loss of appetite, cough, sore throat, runny nose, nausea, and weakness.
How It Spreads
Flu spreads by virusinfected droplets coughed or sneezed into the air.
Incubation Period
Symptoms usually appear one to four days after exposure to the virus.
How Long Symptoms Last
Fever and most other symptoms subside within 5 days, but cough and weakness may persist. All symptoms are usually gone within 7 to 14 days.
When to Call Your Child’s Doctor
Children with mild cases usually don’t need to see their doctor. Do call your child’s doctor if your child has a fever of 103 degrees Fahrenheit or higher, if your child—especially your infant younger than three months—has a cough that does not get better over a three- to four-day period, or if your child is having difficulty breathing. A persistent cough, fever, increased breathing rate, or respiratory difficulty may indicate that your child has developed pneumonia as a complication of the flu.
How the Diagnosis Is Made
The doctor will examine your child and listen to the lungs to determine whether any complications have developed, such as pneumonia. If pneumonia is suspected, a chest X-ray may be ordered.
Treatment
Because the flu is caused by a virus, it is not treated with antibiotics unless there is a secondary bacterial infection. Some children with chronic medical conditions may require hospitalization. For a very ill child or one with other conditions that may predispose him to complications, a doctor may prescribe an antiviral medication to relieve symptoms; the medicine must be given within 48 hours of the onset of symptoms.
Home Treatment
Children should rest in bed or play quietly. Give a nonaspirin medication such as acetaminophen (Tylenol) to relieve fever and aches. Do not give aspirin because it is associated with Reye syndrome, a rare but potentially fatal disease, especially if given to a child with influenza or chicken pox.
Prevention
Try to keep your child away from crowds during an epidemic. Make sure that your child washes his hands thoroughly and doesn’t pick up used tissues. The flu vaccine is not routinely recommended for children, except those with chronic heart or lung diseases (including asthma), sickle-cell anemia, diabetes, HIV, or other chronic conditions.
Contagious Periods
The contagious period lasts from the day before to seven days after symptoms appear.
Complications
Pneumonia (infection and inflammation of the lung), caused by the virus and/or a secondary bacterial infection, and otitis media (middle ear infection) are the most common complications. Myocarditis (an infection of the heart) and Reye syndrome are rare complications.
There are three types of influenza virus: Type A is usually responsible for large epidemics and is constantly changing with new strains appearing. Type B causes smaller, more localized outbreaks. Type C is less common and usually causes mild illness. Flu epidemics usually occur between November and March.
Symptoms
Flu symptoms may be similar to those of the common cold, but they tend to develop quickly and are more severe. They can include fever (often sudden and high), chills, headache, muscle aches, dizziness, loss of appetite, cough, sore throat, runny nose, nausea, and weakness.
How It Spreads
Flu spreads by virusinfected droplets coughed or sneezed into the air.
Incubation Period
Symptoms usually appear one to four days after exposure to the virus.
How Long Symptoms Last
Fever and most other symptoms subside within 5 days, but cough and weakness may persist. All symptoms are usually gone within 7 to 14 days.
When to Call Your Child’s Doctor
Children with mild cases usually don’t need to see their doctor. Do call your child’s doctor if your child has a fever of 103 degrees Fahrenheit or higher, if your child—especially your infant younger than three months—has a cough that does not get better over a three- to four-day period, or if your child is having difficulty breathing. A persistent cough, fever, increased breathing rate, or respiratory difficulty may indicate that your child has developed pneumonia as a complication of the flu.
How the Diagnosis Is Made
The doctor will examine your child and listen to the lungs to determine whether any complications have developed, such as pneumonia. If pneumonia is suspected, a chest X-ray may be ordered.
Treatment
Because the flu is caused by a virus, it is not treated with antibiotics unless there is a secondary bacterial infection. Some children with chronic medical conditions may require hospitalization. For a very ill child or one with other conditions that may predispose him to complications, a doctor may prescribe an antiviral medication to relieve symptoms; the medicine must be given within 48 hours of the onset of symptoms.
Home Treatment
Children should rest in bed or play quietly. Give a nonaspirin medication such as acetaminophen (Tylenol) to relieve fever and aches. Do not give aspirin because it is associated with Reye syndrome, a rare but potentially fatal disease, especially if given to a child with influenza or chicken pox.
Prevention
Try to keep your child away from crowds during an epidemic. Make sure that your child washes his hands thoroughly and doesn’t pick up used tissues. The flu vaccine is not routinely recommended for children, except those with chronic heart or lung diseases (including asthma), sickle-cell anemia, diabetes, HIV, or other chronic conditions.
Contagious Periods
The contagious period lasts from the day before to seven days after symptoms appear.
Complications
Pneumonia (infection and inflammation of the lung), caused by the virus and/or a secondary bacterial infection, and otitis media (middle ear infection) are the most common complications. Myocarditis (an infection of the heart) and Reye syndrome are rare complications.
Hepatitis, Viral
Cause
This inflammation of the liver is usually caused by infection with one of three hepatitis viruses: hepatitis A virus (HAV), hepatitis B virus (HBV), or hepatitis C virus (HCV). Viral hepatitis can also occur with cytomegalovirus (CMV), Epstein-Barr virus (the virus that causes infectious mononucleosis), and other viral infections.
Symptoms
In the early stages of the illness, flulike symptoms are common in hepatitis A and hepatitis B and less frequent (less than 25 percent of cases) in hepatitis C. Symptoms may be very mild or may not occur in many children. These may include fever, malaise, muscle aches, loss of appetite, nausea, vomiting, and diarrhea. Jaundice (yellowing of the skin and whites of the eyes) may or may not occur in children with these infections. Tenderness over the swollen, inflamed liver (right upper abdomen) or swollen spleen (left upper abdomen) may be present. The urine may become dark (“tea-colored”), and the stools may become white or “clay-colored.”
How It Spreads
Hepatitis A infection occurs when a person touches or eats anything that has been contaminated with HAV-infected stool, such as water, milk, and foods (especially shellfish from sewage-contaminated waters). It spreads easily in overcrowded or unsanitary conditions and among young children who may not be suspected of having the illness because of mild or absent symptoms. Hepatitis B spreads through infected body fluids including blood, saliva, semen, vaginal fluids, breast milk, and urine.
Infected infants usually have acquired the virus during the birth process from their HBV-carrier mothers. Hepatitis C usually spreads to children through transfused blood products, particularly with repeated blood product exposure as with chronic hemodialysis in a child with kidney failure. The virus may be passed from mother to infant, especially if the mother is also infected with HIV.
Incubation Period
The incubation period for hepatitis A is 2 to 6 weeks; for hepatitis B, it’s one to five months; for hepatitis C, it’s 2 to 26 weeks.
How Long Symptoms Last
Almost all previously healthy children with hepatitis A infection will recover fully within a few weeks or months. If symptoms develop with hepatitis B infection, they usually subside within six to eight weeks, but chronic infection with the virus can occur and can lead to liver damage and liver cancer.
Chronic infection with the virus is particularly common (70 to 90 percent) in infants who acquire the infection from their mothers at birth and are not treated. Children with hepatitis C usually have no symptoms but are at risk for future liver damage due to chronic infection with the virus.
When to Call Your Child’s Doctor
Your child’s doctor should be called for any child who develops jaundice or the other symptoms of hepatitis described earlier or whobecomes very drowsy or confused. Also contact the doctor if your child has had contact with others with viral hepatitis or if your child will be traveling to an area where hepatitis infection is common.
How the Diagnosis Is Made
The doctor suspects the diagnosis based on the child’s symptoms; inflammation of the liver and infection with a specific hepatitis virus can be detected by blood tests.
Treatment
Children with hepatitis who develop symptoms typically need no specific treatment other than specific supportive care—plenty of rest and adequate fluid intake to prevent dehydration. In a child with a poor appetite due to hepatitis, offering smaller, more frequent meals and fluidsthat are high in calories (like milk shakes) may help ensure that the child receives adequate nutrition while recovering. Some children whose symptoms are more severe may require hospitalization to receive IV fluids and other treatment.
Prevention
The risk of exposure to hepatitis A can be reduced by following good hygiene—including hand washing—and avoiding crowded, unsanitary living conditions or drinking or swimming in contaminated water. Shellfish from sewage contaminated waters should not be eaten. If someone in the household develops hepatitis, antiseptic cleansers should be used to clean any toilet, sink, potty chair, or bedpan used by that person.
A hepatitis A vaccine is available, and it is recommended for children traveling to areas of the world where the risk of exposure to the virus is high. The staffs of child-care facilities, family members of infected persons, and sexual partners of someone with the infection are also candidates to receive the vaccine. Giving immune globulin within one to two weeks after exposure to the virus can prevent illness from developing in 80 to 90 percent of individuals.
Hepatitis B infection from transfusions is very rare in the United States today because blood products are screened for the presence of the virus. Hepatitis B vaccine is now recommended for routine immunization of all infants and for adolescents who didn’t receive the vaccine in infancy. Hepatitis B infection in infants and young children is usually the result of transmission of the disease at birth by an infected mother who carries the virus.
Pregnant women should be screened for the virus, and if a woman is found to be a carrier, her infant should be given a dose of hepatitis B immune globulin (HBIG) at birth, followed by the recommended doses of the vaccine. In the United States, blood and plasma donors are screened for HCV infection. At present, there is no vaccine for the prevention of hepatitis C.
Complications
Although children with HAV infection almost always recover fully without specific treatment, children with chronic HBV and HCV infections are at increased risk for the development of liver damage (cirrhosis), liver failure, and liver cancer as they get older. It is important that these individuals be followed medically for signs of these complications. New drugs, such as interferon alpha, may be helpful in some cases, and patients who develop liver failure may receive liver transplants.
This inflammation of the liver is usually caused by infection with one of three hepatitis viruses: hepatitis A virus (HAV), hepatitis B virus (HBV), or hepatitis C virus (HCV). Viral hepatitis can also occur with cytomegalovirus (CMV), Epstein-Barr virus (the virus that causes infectious mononucleosis), and other viral infections.
Symptoms
In the early stages of the illness, flulike symptoms are common in hepatitis A and hepatitis B and less frequent (less than 25 percent of cases) in hepatitis C. Symptoms may be very mild or may not occur in many children. These may include fever, malaise, muscle aches, loss of appetite, nausea, vomiting, and diarrhea. Jaundice (yellowing of the skin and whites of the eyes) may or may not occur in children with these infections. Tenderness over the swollen, inflamed liver (right upper abdomen) or swollen spleen (left upper abdomen) may be present. The urine may become dark (“tea-colored”), and the stools may become white or “clay-colored.”
How It Spreads
Hepatitis A infection occurs when a person touches or eats anything that has been contaminated with HAV-infected stool, such as water, milk, and foods (especially shellfish from sewage-contaminated waters). It spreads easily in overcrowded or unsanitary conditions and among young children who may not be suspected of having the illness because of mild or absent symptoms. Hepatitis B spreads through infected body fluids including blood, saliva, semen, vaginal fluids, breast milk, and urine.
Infected infants usually have acquired the virus during the birth process from their HBV-carrier mothers. Hepatitis C usually spreads to children through transfused blood products, particularly with repeated blood product exposure as with chronic hemodialysis in a child with kidney failure. The virus may be passed from mother to infant, especially if the mother is also infected with HIV.
Incubation Period
The incubation period for hepatitis A is 2 to 6 weeks; for hepatitis B, it’s one to five months; for hepatitis C, it’s 2 to 26 weeks.
How Long Symptoms Last
Almost all previously healthy children with hepatitis A infection will recover fully within a few weeks or months. If symptoms develop with hepatitis B infection, they usually subside within six to eight weeks, but chronic infection with the virus can occur and can lead to liver damage and liver cancer.
Chronic infection with the virus is particularly common (70 to 90 percent) in infants who acquire the infection from their mothers at birth and are not treated. Children with hepatitis C usually have no symptoms but are at risk for future liver damage due to chronic infection with the virus.
When to Call Your Child’s Doctor
Your child’s doctor should be called for any child who develops jaundice or the other symptoms of hepatitis described earlier or whobecomes very drowsy or confused. Also contact the doctor if your child has had contact with others with viral hepatitis or if your child will be traveling to an area where hepatitis infection is common.
How the Diagnosis Is Made
The doctor suspects the diagnosis based on the child’s symptoms; inflammation of the liver and infection with a specific hepatitis virus can be detected by blood tests.
Treatment
Children with hepatitis who develop symptoms typically need no specific treatment other than specific supportive care—plenty of rest and adequate fluid intake to prevent dehydration. In a child with a poor appetite due to hepatitis, offering smaller, more frequent meals and fluidsthat are high in calories (like milk shakes) may help ensure that the child receives adequate nutrition while recovering. Some children whose symptoms are more severe may require hospitalization to receive IV fluids and other treatment.
Prevention
The risk of exposure to hepatitis A can be reduced by following good hygiene—including hand washing—and avoiding crowded, unsanitary living conditions or drinking or swimming in contaminated water. Shellfish from sewage contaminated waters should not be eaten. If someone in the household develops hepatitis, antiseptic cleansers should be used to clean any toilet, sink, potty chair, or bedpan used by that person.
A hepatitis A vaccine is available, and it is recommended for children traveling to areas of the world where the risk of exposure to the virus is high. The staffs of child-care facilities, family members of infected persons, and sexual partners of someone with the infection are also candidates to receive the vaccine. Giving immune globulin within one to two weeks after exposure to the virus can prevent illness from developing in 80 to 90 percent of individuals.
Hepatitis B infection from transfusions is very rare in the United States today because blood products are screened for the presence of the virus. Hepatitis B vaccine is now recommended for routine immunization of all infants and for adolescents who didn’t receive the vaccine in infancy. Hepatitis B infection in infants and young children is usually the result of transmission of the disease at birth by an infected mother who carries the virus.
Pregnant women should be screened for the virus, and if a woman is found to be a carrier, her infant should be given a dose of hepatitis B immune globulin (HBIG) at birth, followed by the recommended doses of the vaccine. In the United States, blood and plasma donors are screened for HCV infection. At present, there is no vaccine for the prevention of hepatitis C.
Complications
Although children with HAV infection almost always recover fully without specific treatment, children with chronic HBV and HCV infections are at increased risk for the development of liver damage (cirrhosis), liver failure, and liver cancer as they get older. It is important that these individuals be followed medically for signs of these complications. New drugs, such as interferon alpha, may be helpful in some cases, and patients who develop liver failure may receive liver transplants.
Hand, Foot, and Mouth Disease
Cause
Certain strains of the Group A coxsackieviruses cause this disease.
Symptoms
Symptoms include fever (usually mild) and malaise, followed by a characteristic rash: red bumps and/or blisters on the hands and feet, along with blisters and ulcers on the tongue and the inner linings of the cheeks. Most outbreaks occur during summer and fall.
How It Spreads
It spreads person-to-person through stool and respiratory fluids.
Incubation Period
The incubation period is four to six days.
How Long Symptoms Last
Symptoms last four to seven days. Mouth pain is usually gone by about four days; mouth blisters are usually gone within one week.
When to Call Your Child’s Doctor
Call your child’s doctor if your child develops a rash on the hands and feet and blisters or ulcers in the mouth. Call the doctor if your child will not eat or drink, shows signs of dehydration, or has fever for more than three days.
How the Diagnosis Is Made
The doctor observes the characteristic rash and mouth lesions.
Home Treatment
Nonprescription drugs such as acetaminophen (Tylenol) can be given to reduce fever or mouth and throat soreness. Do not give aspirin. Fluids such as water, ice chips, fruit ices, or cool gelatin can help relieve a sore mouth or throat. Avoid giving your child acidic, hot, or spicy foods that may irritate a sore mouth.
Prevention
Encourage your child to wash his hands after going to the bathroom and blowing his nose and before and after eating. If changing the diaper of your child with the virus, make sure to wash your hands afterward. Also, wash your child’s towels and sheets.
Complications
A child can become dehydrated from inadequate fluid intake due to mouth pain. Inflammation of the brain (encephalitis) and membranes covering the brain and spinal cord (meningitis) can occur.
Certain strains of the Group A coxsackieviruses cause this disease.
Symptoms
Symptoms include fever (usually mild) and malaise, followed by a characteristic rash: red bumps and/or blisters on the hands and feet, along with blisters and ulcers on the tongue and the inner linings of the cheeks. Most outbreaks occur during summer and fall.
How It Spreads
It spreads person-to-person through stool and respiratory fluids.
Incubation Period
The incubation period is four to six days.
How Long Symptoms Last
Symptoms last four to seven days. Mouth pain is usually gone by about four days; mouth blisters are usually gone within one week.
When to Call Your Child’s Doctor
Call your child’s doctor if your child develops a rash on the hands and feet and blisters or ulcers in the mouth. Call the doctor if your child will not eat or drink, shows signs of dehydration, or has fever for more than three days.
How the Diagnosis Is Made
The doctor observes the characteristic rash and mouth lesions.
Home Treatment
Nonprescription drugs such as acetaminophen (Tylenol) can be given to reduce fever or mouth and throat soreness. Do not give aspirin. Fluids such as water, ice chips, fruit ices, or cool gelatin can help relieve a sore mouth or throat. Avoid giving your child acidic, hot, or spicy foods that may irritate a sore mouth.
Prevention
Encourage your child to wash his hands after going to the bathroom and blowing his nose and before and after eating. If changing the diaper of your child with the virus, make sure to wash your hands afterward. Also, wash your child’s towels and sheets.
Complications
A child can become dehydrated from inadequate fluid intake due to mouth pain. Inflammation of the brain (encephalitis) and membranes covering the brain and spinal cord (meningitis) can occur.
Epiglottitis
Cause
Epiglottitis is an inflammation of the child’s epiglottis, the flap of tissue that covers the windpipe, and is usually caused by the bacterium Hemophilus influenzae type B. Epiglottitis occurs most often in children age three to seven years, and it is more common in the fall and spring.
Symptoms
Symptoms may develop very rapidly. The child may have symptoms of an upper respiratory infection. As the epiglottis becomes inflamed and begins to swell, the throat becomes sore and painful and the child’s temperature may rise to 102 to 104 degrees Fahrenheit. The child may begin to drool because swallowing is painful. The voice may sound muffled.
Within hours, the child may develop breathing difficulty. With each breath, the child may make a high-pitched squeaking sound (stridor). The nostrils may flare out as the child breathes. The child may appear anxious and want to sit up, holding the head and neck forward to help him breathe. The lips and fingertips may start to turn blue as less oxygen gets into the bloodstream. If not treated quickly, a child with this infection may die due to blockage of the windpipe by the swollen epiglottis.
How It Spreads
The bacteria, found in nasal secretions, are spread when a person who may carry the bacteria without even being sick coughs or sneezes.
How Long Symptoms Last
Symptoms usually improve quickly with treatment, but the child usually needs to stay in the hospital for several days to a week.
When to Call Your Child’s Doctor
Bring your child to the emergency room immediately if she shows the symptoms described. Epiglottitis can be deadly if not treated quickly.
How the Diagnosis Is Made
Doctors suspect the diagnosis based on a child’s symptoms. Your child is then usually taken to an operating room where a doctor will insert a lighted thin tube into the throat to see if the epiglottis is inflamed and swollen. It may appear cherry red. The swollen epiglottis can also be seen on an X-ray of the neck.
Treatment
A specialist may insert a breathing tube into the windpipe to hold the airway open. Your child may then be placed on a ventilator (breathing machine) in the hospital to help her breathe. Intravenous antibiotics are given to kill the bacteria causing the infection. When the infection and swelling of the epiglottis subside with treatment, the breathing tube can be removed.
Prevention
The incidence of epiglottitis has decreased dramatically since the vaccine against Hemophilus influenzae type B was introduced. Infants should be immunized against this bacterium, which also causes meningitis and pneumonia. If your child develops epiglottitis, your child’s doctor may recommend that anyone in the household not fully vaccinated (except pregnant women) receive a course of the antibiotic rifampin. The doctor may recommend the same for anyone not fully vaccinated at your child’s school or child-care center.
Epiglottitis is an inflammation of the child’s epiglottis, the flap of tissue that covers the windpipe, and is usually caused by the bacterium Hemophilus influenzae type B. Epiglottitis occurs most often in children age three to seven years, and it is more common in the fall and spring.
Symptoms
Symptoms may develop very rapidly. The child may have symptoms of an upper respiratory infection. As the epiglottis becomes inflamed and begins to swell, the throat becomes sore and painful and the child’s temperature may rise to 102 to 104 degrees Fahrenheit. The child may begin to drool because swallowing is painful. The voice may sound muffled.
Within hours, the child may develop breathing difficulty. With each breath, the child may make a high-pitched squeaking sound (stridor). The nostrils may flare out as the child breathes. The child may appear anxious and want to sit up, holding the head and neck forward to help him breathe. The lips and fingertips may start to turn blue as less oxygen gets into the bloodstream. If not treated quickly, a child with this infection may die due to blockage of the windpipe by the swollen epiglottis.
How It Spreads
The bacteria, found in nasal secretions, are spread when a person who may carry the bacteria without even being sick coughs or sneezes.
How Long Symptoms Last
Symptoms usually improve quickly with treatment, but the child usually needs to stay in the hospital for several days to a week.
When to Call Your Child’s Doctor
Bring your child to the emergency room immediately if she shows the symptoms described. Epiglottitis can be deadly if not treated quickly.
How the Diagnosis Is Made
Doctors suspect the diagnosis based on a child’s symptoms. Your child is then usually taken to an operating room where a doctor will insert a lighted thin tube into the throat to see if the epiglottis is inflamed and swollen. It may appear cherry red. The swollen epiglottis can also be seen on an X-ray of the neck.
Treatment
A specialist may insert a breathing tube into the windpipe to hold the airway open. Your child may then be placed on a ventilator (breathing machine) in the hospital to help her breathe. Intravenous antibiotics are given to kill the bacteria causing the infection. When the infection and swelling of the epiglottis subside with treatment, the breathing tube can be removed.
Prevention
The incidence of epiglottitis has decreased dramatically since the vaccine against Hemophilus influenzae type B was introduced. Infants should be immunized against this bacterium, which also causes meningitis and pneumonia. If your child develops epiglottitis, your child’s doctor may recommend that anyone in the household not fully vaccinated (except pregnant women) receive a course of the antibiotic rifampin. The doctor may recommend the same for anyone not fully vaccinated at your child’s school or child-care center.
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