Roseola infantum

Roseola is also called exanthem subitum and is a common childhood virus caused by the human herpesvirus 6 or 7. The disease usually occurs in children younger than 4 years.

• Symptoms
  • The symptoms are a high, spiking fever for up to 8 days followed by the onset of a rash.
  • The rash is small, pink, flat, or slightly raised lesions that appear on the trunk and spread to the extremities.
• Treatment
  • Despite the worrisome fever, the disease is not harmful and gets better without specific therapy. Fever can be managed with acetaminophen. Aspirin and aspirin-like products should ALWAYS be avoided in children as it can cause a life-threatening condition called Reye's syndrome.
  • The fever associated with roseola can cause a seizure.

Coxsackieviruses and other enteroviruses

The enteroviruses, including the coxsackieviruses, are a very common cause of fever and rash in children. Two diseases are caused by coxsackieviruses, called hand-foot-and-mouth disease and herpangina. Coxsackievirus infections are more common in the summer and autumn.

• Symptoms
  • In hand-foot-and-mouth disease, the children develop fever and rash. The rash includes blisters to the mouth and tongue and to the hands and the feet.
  • Herpangina causes a fever, sore throat, and painful blisters or ulcers on the back of the mouth that cause difficulty swallowing. Children may also have loss of appetite, abdominal pain, and rarely vaginal ulcers.
• Treatment
  • No specific treatment is available except acetaminophen (Tylenol) or ibuprofen (Advil) for fever. Aspirin and aspirin-like products should ALWAYS be avoided in children as it can cause a life-threatening condition called Reye's syndrome.
  • The diseases are not harmful but can be prevented with good hand washing and not eating off someone else's plate or sharing straws.

Impetigo

Impetigo is a superficial skin infection with streptococcal or staphylococcal bacteria. It is often found around the nose and mouth but can occur anywhere. The rash is more common in the warmer months. It can also be an additional infection to skin that has been damaged, such as in scabies, poison ivy, eczema, or drug reactions.

• Symptoms
  • Impetigo begins as small superficial blisters that rupture leaving red, open patches of skin.
  • Often a honey-colored crust forms over this rash.
  • The rash is very itchy.
  • Impetigo is also highly contagious. A child can spread the infection to other parts of the body or to other people.
• Treatment
  • This infection of the skin is easily treated with topical or oral antibiotics.
  • Your child usually is no longer contagious after 2-3 days of therapy, and the rash begins to heal in 3-5 days.
  • If the rash does not show signs of healing by the third day of treatment, your child needs to be seen by your doctor.
  • When the impetigo occurs in addition to poison ivy or scabies, your child may benefit from an anti-itch medication while the antibiotics are taking effect.

Life-Threatening Rashes

Life-threatening rashes are uncommon, and your child usually appears quite ill if he or she has a life-threatening rash. If you suspect your child may have a life-threatening rash, you should go to your hospital's emergency department immediately.

Fever and petechiae

These two symptoms are present with many rashes and are often signs of a more serious condition. Children can develop petechiae from a number of causes. It is not unusual for forceful coughing or vomiting to cause petechiae on the face and chest. Petechia with fever is more concerning, although most of these children have a viral illness that does not require any therapy. A small percentage (2-7%) may have diseases that need immediate evaluation. Any child with a fever and petechiae should be seen by a doctor immediately.

• Symptoms
  • Petechiae are red dots on the skin that do not fade when pressure is applied. The dots represent bleeding from the capillaries leaving a small, temporary blood blister in the skin.
  • Children with petechiae may appear healthy or very ill.
• Treatment
  • Petechiae resolve completely without any treatment. However, a doctor should evaluate your child to determine that a serious disease process is not present.
  • Your child may need blood tests and x-rays to find the cause of the petechiae and fever.
  • Occasionally, a child also requires a lumbar puncture (spinal tap) to be sure meningitis is not the cause.

Meningococcemia

Also called, meningococcal sepsis, meningococcemia is a life-threatening bacterial invasion of the blood by bacteria called Neisseria meningitidis. This disease is seen primarily in the winter and spring in children younger than 2 years. Meningococcemia is spread from the nose and mouth of other people. Good hygiene and hand washing can help decrease the risk of transmission. Children exposed to people with this disease need to be evaluated by their doctor and possibly be put on antibiotics to protect them from getting the disease. (Other bacteria such as Haemophilus influenzae, Streptococcus pneumoniae, and Staphylococcus aureus can cause similar syndromes.)

• Symptoms
  • Fever and a petechial rash are present.
  • Headache, congestion, nausea, vomiting, and muscle aches may also occur.
  • The rash may start out as small bumps or raised blisters but develop into petechiae.
  • Petechiae are broken capillaries in the skin that cause red dots that do not disappear when pressure is applied to the skin.
• Treatment
  • Take a child with the symptoms of meningococcemia to your hospital's emergency department immediately.
  • Blood tests, including blood cultures, may be needed, as may x-rays and a spinal tap, to fully evaluate your child
  • Meningococcemia is treated in the hospital with IV antibiotics. Intensive care therapy may also be required.
  • Meningococcus can be fatal even with appropriate antibiotic therapy. Early treatment and close observation are needed.