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Dengue Fever: An Overview

Dengue is caused by the mosquito Aedes aegypti which can usually be found in the tropical areas of the world and has been considered to be one of the major health threats locally and overseas. Being the most popular and common arboviral illness, dengue has been of the focus of the world Health Organization (WHO).

Assessment and Findings

  • It is very important to tell parents that children with dengue can manifest a fever as high as 41°C. Fever may begin on the third day of the incubation period which can last up to 7 days. The term saddle back fever is commonly used to connote appearance, abatement and reappearance of fever. To add up, an elevated body temperature is usually preceded by mottling of skin, a flushed face, erythematic skin and chills.
  • Headache can be present causing an altered comfort to children.
  • Nausea and vomiting may be present in some cases.
  • Maculopapular rashes or confluent of the face, thorax and other parts of the body can be seen.
  • Myalgia or muscle pain may be reported especially in the major bony prominences.
  • Hemorrhagic symptoms may likely to happen from epistaxis (nosebleeding), hematemesis (vomiting blood) and hematochezia (blood in stool).
  • Abdominal pain may be reported.
  • Drop in the platelet count happens.
  • Flu like symptoms can happen such that of nasal congestion and sore throat.

Management

Symptomatic management are provided which means for every manifested symptom, a specific intervention or medical treatment can be done and they are as follows:

  1. Anti pyretic like Paracetamol for fever.
  2. Analgesics for muscle pain and headache.
  3. Histamine blockers and Proton pump inhibitors may be administered to patients with gastrointestinal symptoms.
  4. Insertion of venoclysis or intravenous fluids to maintain fluid and electrolyte status.
  5. Transfusion of platelet component as necessary to avoid persistent bleeding.
  6. Hematinics or drugs preventing hemorrhage for patients with hemorrhagic manifestations.

Other forms of management are supportive in nature to prevent complications and conserve the remaining body strength and resistance.

  • Hydrate the child and force fluids as tolerated.
  • Intake of multivitamins and other essential supplementations to boost the immune system.
  • Provide and allow adequate periods of rest and relaxation.
  • Incorporation of fruits and vegetables to the diet.

The etiology and manifestations of dengue fever are very important to prevent the child from developing complications or worst to experience premature death. Parents should take the responsibility in monitoring the soft of their children and provision of a conducive environment free from vectors which can be carriers of the virus. Moreover, if symptoms do manifest, fever and its accompanying symptoms should not be taken for granted.

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How to Treat Child Illnesses at Home

Parents are always hoping that their children would not get sick but it is inevitable that most children with their underdeveloped bodies and immune system, they  tend to be stricken with common diseases every once in a while. Parents would need to be ready to take care of their children at home for diseases that are not so serious for hospital confinement. Here are a few tips on how and when to treat child illnesses at home.

  1. Insect bites – probably the most common problem in children that plays around the house a lot. Children can easily get insect bites if they aren’t wearing clothes that fully cover their extremities. If children will play outside parents should put a mosquito lotion on their exposed skin to prevent insect bites from disease carrying vectors such as mosquitoes. It will also be helpful to dress them with cotton long sleeves and pants for full coverage of the skin.
  2. Sore throat – many children are prone to get sore throats characterized by redness of the area, difficulty is swallowing and fever. Sore throats may be caused by a bacterial infection that is treated with antibiotics. Consult your doctor before starting any antibiotic treatments. For home treatment for children with sore throat make sure they are well rested and offer lots of fluid to ease pain and dryness in the throat.
  3. Pink eye – the inner eyelids and the white portion of the eye is reddened. This causes itchiness; swelling and a greenish yellow discharge may be present. Placing a warm clean wash cloth will ease the pain and discomfort and can easily wipe the discharge off the eye for better visualization. Consult your doctor for prescription eye drops to remove any bacterial infection. Make sure that your child has plenty of rest and washes his or her hands frequently to avoid contaminating others.
  4. Fever – is not a condition in itself but a symptom of an underlying disease or infection. It is necessary to pinpoint the cause if there are any. Providing care for a child with fever includes limited activities with plenty of rest and sleep. Medication to decrease temperature with the right dosage from the doctor at equal intervals until fever goes away. A tepid sponge bath will help regulate the temperature and provide a soothing feeling for the child.
  5. Colds and runny nose – Children are very susceptible to colds and flu with their weak immune system and close proximity to other infected individuals in school. Parents can use a suction bulb to suck out gently the mucus out from the sinuses. Increasing oral fluid intake is beneficial to replace lost fluids from the body and will further loosen the mucus. Serve nutritious foods to your sick child and give them lots of fruits rich in vitamin C to boost their immune system to help fight off the disease.

When caring for a sick child at home remember that they need to rest so give them fun activities that can be done while in bed like watching cartoon movies, reading books and coloring. This will remove boredom while maintaining a resting environment for the child to fully recover.

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Fever Higher than 102 Degrees Fahrenheit

When a child has a fever, it indicates one or more types of medical conditions, and one of them includes infections. The normal body temperature of children as well as adults is at 98.6 Fahrenheit or 37 degrees Celsius. It has to be noted that even a slight change in the body temperature of children might mean serious infections which should be attended to immediately. This premise is also applicable to newborn children, wherein temperatures which are above normal levels might indicate something serious.

Normally, when a fever is measured lower than 102 degrees Fahrenheit, medical practitioners suggest that you do not treat them. This is because these types of fevers normally subside over time. But if a fever is above 102 degrees Fahrenheit, the doctor might prescribe some over the counter drugs such as Tylenol to make the fever go lower. Though there are a lot of over the counter drugs available out there, it is not advisable to treat children with these medicines; especially aspirin for it might cause serious damage to them.

 

Ways of Taking Temperature

One of the most common tools used for taking a temperature is the thermometer. Most thermometers nowadays are digital because of the fact that they have phased out mercury thermometers for health reasons. Below are some of the ways where you can check a child’s temperature and how to do them:

1. Rectally – the rectal method of taking temperature is recommended for children, especially for newborn and infants. This procedure can be done by first preparing the apparatus to be used for measuring temperature. First, you need to put some lubricants or petroleum jelly on the thermometer bulb to make sure that passage of the thermometer is less painful. The next thing you need to do is to lay him on his stomach for you to be able to do the procedure right. After doing this, insert the thermometer carefully inside the rectum, about 0.5 – 1 inch deep. Finally, let it stay inside the rectum for about three minutes, and read the temperature from there.  

 

2. Orally - the most common approach of taking temperature is done orally. To do this, you should first place the thermometer under the tongue of you child, wait for at least 3 minutes and read the results.

3. Axillary – taking the temperature of a child under the armpit is also widely used but experts claim that the results are not that accurate compared to orally examining it.  

Getting Medical Attention

A parent should immediately call the attention of a medical practitioner in case some of the following symptoms occur:

  1. Abdominal pains
  2. Irritability
  3. Breathing problems
  4. Mental confusions
  5. Rashes and headaches

Taking care of children who has a very high fever could be very tiring and it could be understandable that there are times when we fail to look out for them. In cases like these, it would be best to keep a close eye on your child and at the same time, seek the help of the doctor if the symptoms persist.

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Lyme Disease

Lyme disease is an infection caused by the bacteria Borrelia burgdorferi.  The bacteria is spread by black-legged, weatern black-legged, or deer ticks.

Ticks acquire the bacteria from mice before passing it to humans by biting.  The bacteria enters the human bloodstream and causes the infection.  These ticks can be hard to detect; immature ticks are about the size of a poppy seed, while adults may be as large as a sesame seed.

Children who spend a lot of time outdoors or in wooded areas are most susceptible to developing Lyme disease.  Ticks hide in shrubs, long grass, and forested areas. 

Lyme disease is curable when caught early.  Most infected people will develop what is known as “the bullseye rash”; a distinct, circular rash that allows doctors to diagnose Lyme disease on sight.  Occasionally, a person will not develop the rash; in that case, bloodwork will be used to diagnose the illness.

Lyme disease occurs in three stages.  Ideally, diagnosis and treatment should occur in the first stage for it to be most effective.  It may take a week to a month for your child to develop some or all of these symptoms after being bitten by an infected tick:

  • swelling of the lymph glands near the bite
  • fatigue
  • headache
  • joint pain
  • an overall achy feeling
  • chills

Once Lyme disease progresses to the second stage, it can cause some alarming symptoms, such as:

  • two or more areas of rash not at the site of the bite
  • severe headache
  • tingling or numbness in the extremities
  • enlarged lymph nodes (glands)
  • joint stiffness, especially in the neck
  • severe fatigue
  • sensitivity to light
  • facial paralysis (Bell’s palsy)
  • irregular heart rhythm
  • fever of 100 to 102 degrees Fahrenheit (37.78 to 38.89 degrees Celsius)
  • meningitis

At this point, the illness is quite severe.  If your child is experiencing any of the symptoms mentioned above, they need to be seen by a doctor right away.

Lyme disease that goes undiagnosed can lead to arthritis and cognitive deterioration.

If you suspect that your child has been bitten by a tick, take them to the doctor for bloodwork.  Not everyone shows symptoms.

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Encephalitis

Encephalitis is an inflammation of the brain most commonly caused by a virus.  Your child may show signs of another viral infection before contracting encephalitis.

Several thousand cases of encephalitis are reported to the Center for Disease Control and Prevention (CDC) each year.  Elderly people, children, and those with compromised immune systems are most at risk.

Because encephalitis is caused by many different viruses, the severity and symptoms can vary as well.  A particularly severe form is caused by the Herpes Simplex Virus (the same virus responsible for cold sores). 

Encephalitis can also be a complication of Lyme disease, chickenpox, mumps, measles, and other common childhood infections.  Although encephalitis itself is not contagious, the virus that caused the infection is.  Therefore, you should try to avoid coming into contact with anyone known to have this infection.

A child with mild encephalitis may feel generally unwell, with a poor appetite, fever, and fatigue.  More severe cases may exhibit some of the following symptoms:

  • confusion or mood swings
  • stiff neck
  • a severe headache
  • difficulty hearing or speaking
  • loss of consciousness
  • nausea and vomiting

If you suspect that your child may have encephalitis, you need to take them to the doctor or emergency room immediately.  It may be harder to tell in infants, so watch for:

  • a bulging soft spot (fontanel)
  • vomiting
  • incessant crying that worsens when you pick up Baby

Your doctor may perform a variety of tests to confirm encephalitis, including a CT scan, bloodwork, or a spinal tap.  Most children diagnosed with encephalitis will need to be hospitalized and monitored closely to prevent any further swelling or inflammation of the brain. 

The acute phase of encephalitis can be cleared up in about a week, though full recovery can take a few months.

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Cat Scratch Disease

Cat Scratch Disease is a bacterial infection caused by the bacterium Bartonella henselae.  Children and young adults under 21 seem to be most susceptible to this infection, possibly because they are more likely to be bit, scratched, or licked by a cat.

Fleas carry the bacteria from one cat to another, where it lives in the cat’s saliva.  Cats are basically carriers of the bacteria; they show no signs of infection and do not actually become sick themselves.

Once your child has been scratched or bitten by a cat, they may devlop a small bump or blister at the site.  These are usually not painful.  This is where the bacteria has entered the body. 

Within a few weeks, the lymph nodes closest to the site of the bite or scratch will become infected and swell.  The skin around the lymph node may swell and become red.  An infected lymph node may actually feel warm to the tough, and drain pus.

Most children will experience a mild case of Cat Scratch Disease, with swollen lymph nodes being the only symptom.  About one third of children will develop other symptoms, such as:

  • low-grade fever
  • loss of appetite
  • rash
  • fatigue or sleepiness
  • headache

Rarely, the infection may become so severe that the spleen, liver, lungs, or bones are affected.  In some cases, inflammation of the brain or seizures may occur.  These symptoms usually do not cause any lasting damage.

If you suspect that your chid may have Cat Scratch disease, a trip to the doctor is in order.  They may perform a blood test to see if the bacteria is present in yuor child’s body.  In most cases, the disease will resolve itself without treatment.  In some cases, extremely swollen lymph nodes may need to be drained by the doctor.  Antibiotics can help to clear up secondary symptoms such as spleen or lung infection.

Generally, Tylenol will help to ease any pain that your child may be experiencing.  Once the child has been diagnosed, call the doctor again if any new symptoms develop.

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Urinary Tract Infections

Urinary tract infections (UTIs) are a common problem in childhood.  Though older children may experience symptoms such as bleeding or painful urination, it can be difficult to tell if a younger child or infant has an infection.  Their only symptom may be a fever.

UTIs are more common in girls than boys, particularly around toilet training age.  Girls urethras are shorter and located close to the anus, where they could come in contact with harmful bacteria.

A UTI occurs when bacteria enters the urinary tract, which is composed of the urethra, bladder, kidneys, and ureters.  The urinary tract is designed to flush waste from the body.  An infection can occur anywhere along this tract, though it is most common for infection to develop in the urethra or bladder.

An infection in the bladder is referred to as cystitis.  If the infection travels up the ureters to the kidney, a more serious infection called pyelonephritis will develop.  It is important to catch the infection early, before it has a chance to do damage to the kidneys. 

E.coli is the most common cause of UTIs, introduced to the urinary tract because of its close proximity to the rectum.  It is important to teach children to wipe properly, from front to back, after using the washroom, and to wash their hands thoroughly.  You should also teach your child to urinate when they feel that they need to, instead of waiting, as urine is a great place for bacteria to flourish.

You may suspect that your infant or toddler has a UTI if they:

  • develop a persistent fever for no other apparent reason
  • seem irritable or grumpy
  • have frequent bouts of diaper rash
  • are feeding poorly or vomiting

Take the child to a doctor immediately and tell them of your suspicions.  A UTI is easy to diagnose and treat.

Older children may experience some of the following symptoms when experiencing a UTI:

  • pain, burning, or stinging when urinating
  • cloudy-looking or bloody urine
  • waking at night to use the washroom
  • bedwetting after toilet training
  • pain in the lower back or abdomen
  • an urge to urinate when little urine is actually produced

Early diagnosis and treatment is the key to preventing damage to the child’s kidneys.  This is especially concerning in children under the age of 6.

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Treating your child’s fever

If your child has a fever, then the first thing to do is to reach for your trusty thermometer and see how bad that fever is.  According to the American Academy of Pediatrics, these are the vital temperatures to be looking out for:

 
A baby under two months – needs to see the doctor, if his or her rectal temperature is 100.4 or greater.
A child of six months or older – needs to see the doctor if his or her temperature is over 101 fahrenheit.

 
But what should an anxious parent do if there is a fever – but it’s not bad enough to see a doctor?  A good idea is to keep the room cool (but not too cool!) and dress your child in loose, comfortable clothes.  Make sure your child drinks plenty of water or diluted juice.  If your child is over six months, a mild painkiller may help – but not aspirin.

 
When should you visit the doctor if the fever doesn’t break?  It’s suggested that a fever lasting more than 24 hours for an under two warrants a doctor’s visit, or 72 hours if your child is over two.

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