Childhood skin diseases with rash. Exactly! Measles, chickenpox, rubella and other infectious diseases in children
During the first few years of life, any, even the healthiest child, suffers from childhood infectious diseases. After that, the body has an immunological memory for certain types of viruses, which allows the child to not get sick with these diseases in the future. It has long been known that it is necessary to recover from childhood infectious diseases precisely in childhood, when the process is easier to tolerate. Doctors have a task - to identify the disease in time, differentiate it and competently help the body fight the disease. What are the main childhood infectious diseases? How do they differ from each other in the clinical picture?
What is the rash in the main childhood infectious diseases?
The main childhood infectious diseases are: measles, mumps, rubella, chicken pox, scarlet fever and erythema infectiosum. The ways of infection with these children's infectious diseases are airborne. Scarlet fever has the shortest incubation period - from several hours to 7 days. Erythema infectiosum and measles have an incubation period of 1-2 weeks, mumps, measles and chickenpox have the longest incubation period of 2-3 weeks.
The symptom of intoxication, which implies headache, severe weakness, body aches and whims of the child, is most pronounced in bark and scarlet fever, in other diseases moderate intoxication. Accordingly, an increase in body temperature in measles and scarlet fever can reach 40 0 C and above. But the main criterion that is taken into account in the diagnosis of childhood infectious diseases is the nature of the rash and its localization.
The nature of the rash in childhood infectious diseases:
- Measles is a patchy-papular rash, flat, has a different diameter, polymorphic, can merge. The rash appears in stages, after 3 days.
- Rubella is a small, patchy rash on intact skin that does not merge with each other. No phasing is noted. Exanthema on extensor surfaces. The rash appears from the first day of illness.
- Epidemic mumps - rashes are absent.
- Scarlet fever - small - punctate rash bright red color on hyperemic skin. It merges over time, and a continuous reddening is formed. The rash appears from the first day of illness.
- Chicken pox - characterized by fake polymorphism. That is, at first the element of the rash is roseola, later it turns into a papule, then into a vesicle, then into a pustule with contents. After opening the pustules, crusts form. At the same time, all these elements can be on the skin. The rash with chickenpox is itchy, appears at the end of the first day or at the beginning of the second day.
- Erythema infectiosum - first red dots appear, then spots, which later become swollen with a pale center inside.
Localization of the rash in childhood infectious diseases
It is important not only the nature and timing of the appearance of the rash, but also its localization. Localization of the rash in childhood infectious diseases:
- Measles - A rash appears on the face and behind the ears, spreading to the body and arms.
- Rubella - rashes appear on the face, then spread to the whole body. There are exanthems on the extensor surfaces of the hands, enanthems on the soft palate.
- Scarlet fever - elements of the rash are noted throughout the body, most clearly localized in the folds. The only place where the rash is absent is the nasolabial triangle.
- Chicken pox - rashes on the whole body and face, spreading to the mucous membranes.
- Infectious erythema - the rash appears first on the cheeks, spreading throughout the body.
In addition to the skin, in childhood infectious diseases, the mucous membrane is also subject to pathological changes.
Mucosal changes in childhood infectious diseases
If a child has measles, there are specific changes on the mucous membrane of the oropharynx - Filatov-Koplik spots, which look like small white poppy grains. The mucosa is edematous and plethoric. The child has photophobia and blepharospasm.
With rubella, nasopharyngitis, swelling and enanthems in the soft palate are noted. Scarlet fever is manifested by the presence of a clear boundary between the soft and hard palate, which in medicine is called "burning throat". The soft palate at the same time has a bright red color, delimited from the hard palate. With scarlet fever, tonsillitis develops.
The oropharynx with chicken pox is edematous, hyperemic, aphthous stomatitis is observed. In mumps, the oropharynx is edematous, hyperemic, and there is a positive symptom of Murs (swelling and hyperemia of the stenon duct). Rhinitis is characteristic of erythema infectiosum.
If a child has a childhood infectious disease, specific treatment should be started immediately to avoid life-threatening complications.
Exanthems - rash on the skin. enanthems- rash on mucous membranes.
Exanthems are divided into primary and secondary elements.
Primary elements of the rash: spot, roseola, papule, nodule, blister, vesicle, bladder, hemorrhage.
Spot(macula) - a change in skin color in a limited area that does not rise above the level of the skin and does not differ in density from healthy areas of the skin. Spots distinguish between inflammatory and non-inflammatory. Inflammatory spots are associated with the expansion of the vessels of the dermis. Such spots disappear when the skin is pressed with a finger and reappear after the cessation of pressure.
Types of inflammatory skin changes:
1) roseolous rash (spots less than 5 mm). Multiple roseolas are described as a small pitted rash;
2) small-spotted rash (spots 10-20 mm in size);
3) erythematous rash (spots larger than 20 mm).
Roseolous rash observed in typhoid, typhus, paratyphoid A and B. Small-spotted rash is characteristic of scarlet fever, small-spotted - for rubella, large-spotted occurs with measles, with infectious erythema. Different kinds hemorrhagic rashes occur during inflammatory processes, toxic effects, metabolic disorders, injuries. nodule, papule(papula) - a limited, slightly elevated formation above the level of the skin with a flat, domed surface. Appears due to the accumulation of inflammatory infiltrate in the upper layers of the dermis or the growth of the epidermis. The color of papules can be different. When merging with each other, papules form plaques or entire areas that occupy entire areas of the skin. After healing, they may leave a temporary pigmentation or depigmentation, peeling of the skin.
tubercle(tuberculum) - a limited, dense, cavityless element protruding above the surface of the skin and reaching a diameter of 5 mm. Clinically similar to a papule, but it is denser to the touch and, unlike a papule, necrotic and leaves a scar, an ulcer. Tubercles are characteristic of tuberculous lupus, leprosy, fungal skin lesions.
Knot(nodosum) - a dense, rounded formation. Reaches 10 mm or more in size. It is formed when a cell infiltrate accumulates in the subcutaneous tissue and the dermis proper. May ulcerate and scar. Large, painful blue-red nodules are called erythema nodosum. Non-inflammatory nodes are found in neoplasms. bubble(vesicula) - a formation protruding above the surface of the skin, filled with a serous bloody fluid. Size 1-5 mm. In the process of evolution, it can dry out, forming a transparent or brown crust. After permission leaves a temporary depigmentation or disappear without a trace. The bubble can turn into an abscess - a pustule. The vesicle is characteristic of chicken pox.
Bubble(bulla) - an element similar to a bubble, but much larger in size. It is located in the upper layers of the epidermis, filled with serous bloody purulent contents. After myself
Blister(urtica) - a cavityless element that rises above the surface of the skin, ranging in size from 2-3 to 10-12 mm and more.
Often, when examining a patient, various morphological elements can be found on the skin. A mixture of elements occurs in allergic dermatoses, measles, typhoid fever and other diseases. Secondary morphological elements:
pigmentation and depigmentation; scale (squama);
crust (crusta); scar (cicatrix); erosion (erosio);); fissure (phagaoles); ulcer (ulcus); Pigmentation and depigmentation.
Age spots can occur as a result of the deposition of melanin or hemosiderin in places of the former primary (nodules, vesicles, pustules) and secondary (cracks, erosion) elements of the rash. Hypopigmentation often occurs after scaly and papular elements.
Flake. Accumulation of torn horny plates of the epidermis. Peeling can be leaf-shaped, lamellar, pityriasis. The appearance of scales occurs in scarlet fever, psoriasis, measles, seborrhea.
Crust. It is formed as a result of drying of the contents of vesicles, blisters, pustules. The crusts may be different thickness, various colors.
Scar. An element of healing damaged skin due to the formation of connective tissue. A scar is formed at the site of burns, wounds, knots, pustules, tubercles. Fresh scars fade over time. They can be dense and protruding above the surface of the skin - keloid scars. Atrophic scars are located below the level of the skin. The fabric in this place is thinned. Cicatricial atrophy of the skin occurs without a previous violation of the integrity of the skin.
Erosion. Skin defect within the epidermis. More often it develops as a result of the opening of vesicles, pustules, violation of the integrity of the epidermis on the surface of papules. Healing occurs without a trace, sometimes depigmentation occurs.
Cracks.Linear violations of the integrity of the skin in the form of a gap, resulting from a loss of elasticity. Typical places are the corners of the mouth, interdigital folds, palms, soles, anus.
Ulcer. Deep skin defect, sometimes reaching the underlying organs. It is formed as a result of the decay of the primary elements of the rash, injuries, trophic disorders.
lymphatic system is part of the cardiovascular system. The lymph moves towards the large veins of the neck and here it flows into the bloodstream. The lymphatic system is a branched system of vessels with lymph nodes located along their course. L \ nodes belong to the glandular organ. At infectious diseases
function of lymph nodes consists of microbial retention, localization of infection (production of lymphocytes increases - comes lymphadenopathy
). There are major groups of lymph nodes.
Characteristic changes in the skin, mucous membranes and lymph nodes in some infectious diseases:
With the plague
predominantly local changes in the skin develop. The skin form occurs at the site of penetration of the pathogen. Initially, a painful pustule with dark bloody contents appears, surrounded by a purple shaft protruding above the level of the skin. Then the pustule opens, and an ulcer is formed with a hard, yellow bottom, later covered with a dark scab. The ulcer is very painful and scars for a long time.
The bubonic form is characterized by the development of a painful, immobile bubo surrounded by edema (periadenitis). The skin above the bubo is bright red. Buboes in plague are localized most often in the inguinal-femoral regions. They are so painful that the patients assume an unnatural position. Buboes can dissolve, open with the release of pus, scar.
With tularemia
various groups of lymph nodes increase. An allergic rash may occur. The bubonic form is characterized by the fusion of lymph nodes located close to the site of penetration of the pathogen. Buboes with tularemia are slightly painful, the skin over them is not changed. They can dissolve, scar, suppurate and melt.
The cutaneous bubonic form of tularemia is characterized by the simultaneous appearance of an ulcer and a bubo. At the site of the introduction of the pathogen, a strongly itchy red spot first appears, in the center of which a papule appears, and then a vesicle with cloudy contents. After opening the bladder, an ulcer is formed with a purulent discharge, surrounded by a zone of hyperemia. Then the bottom of the ulcer darkens, a crust forms, after rejection, which remains a scar. At this time, a painless bubo is also formed, most often in the axillary or cervical regions. Buboes suppurate with the formation of a fistula, from which thick pus is released. Buboes dissolve slowly.
With anthrax
the skin form is characterized by local changes in the area of the entrance gate of the pathogen. Initially, a red spot appears, rising above the level of the skin. Then a vesicle is formed, which fester. A painless ulcer develops from the pustule. Around the ulcer marked swelling and hyperemia of the skin. The bottom of the ulcer is covered with a black scab, which is rejected by the end of the 23rd week, the ulcer is scarred.
With HIV infection
lymphadenopathy is one of the most characteristic symptoms. An increase in lymph nodes up to 2-3 cm in diameter is observed in all their groups. They are dense, painful on palpation, not soldered to the skin. HIV infection should be suspected if lymphadenopathy is associated with a decrease in body weight of 10% or more, chronic diarrhea or fever lasting more than one month.
Tactics of a nurse in identifying an infectious rash. If a rash is detected, it is necessary to immediately report to the doctor, collect an epidemiological anamnesis (when the rash appeared, how it appeared - all at once on the whole body or in stages, the localization of the rash, the nature of the rash, whether there was contact with the patient with the rash, what the patient associates with the rash - eating, medicines).
It is necessary to isolate the patient with a rash, to prevent large contact of people. Depending on the nature of the rash, take measures; if a meningococcal infection is suspected, urgent hospitalization. If a rash is detected, take measures of one's own infectious safety (wear a mask, gloves, in case of AGI - protective clothing).
Diagnosis of patients with infectious rash. 1) Collection of epidemiological anamnesis. 2) Clinical data. 3) Laboratory diagnostics: a) bacteriological method (blood culture, urine culture, feces, bile, cerebrospinal fluid, scraping from loose elements); b) serologists
cal method (paired sera).
Organization of nursing care in the syndrome of infectious-inflammatory and infectious-allergic changes in the skin and mucous membranes
With this syndrome, there are:
physiological problems(decrease in the level of hygiene, disgust towards oneself);
psycho-emotional problems(feeling of helplessness, impotence, fear of infecting loved ones, guilt);
social problems(associated with isolation in an infectious diseases hospital, disruption of family communications and a high risk of infecting others). All this depresses the condition of patients.
Nurses should be as delicate as possible with infectious patients suffering from all kinds of skin lesions.
Independent Interventions nurses when caring for patients with inflammatory and allergic skin changes include:
1) conversations about the rules of hygiene, the importance of bed rest and diet food with the restriction of certain foods, such as citrus fruits, chocolate, eggs and other foods containing allergens;
2) the nurse should help the patient cope with the emergence of a feeling of disgust towards himself at the sight of ulcerative, purulent and other skin lesions, dispel his fear and guilt about contracting an infectious disease and inspire hope for a full recovery;
3) seriously ill patients (for example, with anginal-bubonic form of tularemia) it is necessary to treat the mucous membranes of the oral cavity with a 0.05% solution of potassium permanganate or a 0.02% solution of furacillin;
3) wash the affected mucous membranes of the eyes (with the oculobubonic form of tularemia) with a warm 1% soda solution or boiled water, instill 2 drops of 20% albucid 2-3 times a day;
4) for faster resorption of buboes (plague, tularemia), a warming compress is applied to their area;
5) when caring for the skin of a patient with anthrax, it is important for the prevention of sepsis not to injure the skin area on which the anthrax carbuncle has developed, and it is also necessary to convince the patient that he does not open blisters and crusts from the carbuncle;
6) make sure that the patient's clothes (collar, cuffs, belt, elastic bands), belt, watch bracelet do not squeeze the carbuncle and do not rub against its surface. It is necessary to apply a dry sterile or therapeutic bandage carefully so as not to damage the granulation shaft at the border of the focus of necrotic tissues. The dressing must be incinerated.
7) cleanliness control oral cavity, pharynx, nasal passages and perineum; 8) regularly carry out the prevention of bedsores, which are very quickly formed in patients with plague.
9) control over the disinfection of the patient's secretions, care items, premises;
10) carrying out quartzization, ventilation of boxes;
11) preparation of the patient for laboratory and instrumental examination.
Dependent Interventions carried out strictly according to the doctor's prescription.
1. Bed rest. 2. Diet number 13. 3. Fulfillment of doctor's prescriptions: a) etiotropic therapy; b) desensitizing; c) detoxification; d) symptomatic; e) FTL; 4. Sampling of biomaterial for laboratory research.
Children's infections are not accidentally singled out in a special group - firstly, these infectious diseases usually affect children of early and preschool age, secondly, they are all extremely contagious, therefore, almost everyone who has contact with a sick child becomes ill, and thirdly, almost always after a childhood infection, stable lifelong immunity is formed.
There is an opinion that all children need to have these diseases in order not to get sick at an older age. Is it so? The group of childhood infections includes diseases such as measles, rubella, chicken pox, mumps (mumps), scarlet fever. As a rule, children of the first year of life do not get sick with childhood infections. This happens for the reason that during pregnancy, the mother (in the event that she has suffered these infections during her life) passes antibodies to pathogens through the placenta. These antibodies carry information about the microorganism that caused the infectious process in the mother.
After birth, the child begins to receive maternal colostrum, which also contains immunoglobulins (antibodies) to all infections that the mother “met” before pregnancy. Thus, the child receives a kind of vaccination against many infectious diseases. And in the event that breastfeeding continues throughout the first year of a child's life, immunity to childhood infections persists for a longer time. However, there are exceptions to this rule. Unfortunately, there are cases (very rare) when a breast-fed child is susceptible to microorganisms that cause chicken pox, rubella, mumps or measles, even when his mother is immune to them. When does the period end breastfeeding, the child enters the period early childhood. Following this, his circle of contacts expands. It is quite natural that at the same time the risk of any infectious diseases, including childhood infections, increases sharply.
Symptoms and treatment of measles in children
Measles is a viral infection with a very high susceptibility. If a person has not had measles or has not been vaccinated against this infection, then after contact with the patient, infection occurs in almost 100% of cases. The measles virus is highly volatile. The virus can spread through ventilation pipes and elevator shafts - at the same time, children living on different floors of the house fall ill. After contact with a patient with measles and the appearance of the first signs of the disease, it takes from 7 to 14 days.
The disease begins with a severe headache, weakness, fever up to 40 degrees C. A little later, a runny nose, cough and almost complete lack of appetite join these symptoms. The appearance of conjunctivitis is very characteristic of measles - inflammation of the mucous membrane of the eyes, which is manifested by photophobia, lacrimation, sharp redness of the eyes, and subsequently - the appearance of a purulent discharge. These symptoms last 2 to 4 days.
On the 4th day of the disease, a rash appears, which looks like small red spots of various sizes (from 1 to 3 mm in diameter), with a tendency to merge. The rash occurs on the face and head (it is especially characteristic of its appearance behind the ears) and spreads throughout the body for 3 to 4 days. It is very characteristic of measles that the rash leaves behind pigmentation (dark spots that persist for several days), which disappears in the same sequence as the rash appears. Measles, despite the rather bright clinic, is quite easily tolerated by children, but under adverse conditions it is fraught with serious complications. These include inflammation of the lungs (pneumonia), inflammation of the middle ear (otitis media). Such a formidable complication as encephalitis (inflammation of the brain), fortunately, occurs quite rarely. Measles treatment is aimed at relieving the main symptoms of measles and maintaining immunity. It must be remembered that after measles has been transferred for a sufficiently long period of time (up to 2 months), immunosuppression is noted, so the child can get sick with some cold or viral disease, so you need to protect him from excessive stress, if possible - from contact with sick children. After measles, persistent lifelong immunity develops. All those who have had measles become immune to this infection.
Signs of rubella in a child
Rubella is also a viral infection that spreads through the air. Rubella is less contagious than measles and chicken pox. As a rule, children who stay in the same room for a long time with a child who is a source of infection get sick. Rubella is very similar to measles in its manifestations, but it is much easier. The incubation period (the period from contact to the appearance of the first signs of illness) lasts from 14 to 21 days. Rubella begins with an increase in the occipital lymph nodes and () an increase in body temperature to 38 degrees C. A little later, a runny nose joins, and sometimes a cough. A rash appears 2 to 3 days after the onset of the disease.
Rubella is characterized by a pink, punctate rash that begins with a rash on the face and spreads throughout the body. Rubella rash, unlike measles, never merges, there may be a slight itch. The period of rashes can be from several hours, during which there is no trace of the rash, up to 2 days. In this regard, diagnosis can be difficult - if the period of rashes fell at night and went unnoticed by parents, rubella can be regarded as a common viral infection. Rubella treatment is to relieve the main symptoms - the fight against fever, if any, the treatment of the common cold, expectorants. Complications after measles are rare. After suffering rubella, immunity also develops, re-infection is extremely rare.
What is mumps in children
Mumps (mumps) is a childhood viral infection characterized by acute inflammation in the salivary glands. Infection occurs by airborne droplets. Susceptibility to this disease is about 50-60% (that is, 50-60% of those who were in contact and who were not ill and not vaccinated get sick). Mumps begins with an increase in body temperature up to 39 degrees C and severe pain in or under the ear, aggravated by swallowing or chewing. At the same time, salivation increases. Swelling quickly grows in the area of the upper part of the neck and cheeks, touching this place causes severe pain in the child.
By itself, this disease is not dangerous. Unpleasant symptoms pass within three to four days: body temperature decreases, swelling decreases, pain disappears. However, quite often mumps ends with inflammation in the glandular organs, such as the pancreas (pancreatitis), gonads. Past pancreatitis in some cases leads to diabetes mellitus. Inflammation of the gonads (testicles) is more common in boys. This significantly complicates the course of the disease, and in some cases may result in infertility.
In especially severe cases, mumps can be complicated by viral meningitis (inflammation of the meninges), which is severe, but not fatal. After the illness, a strong immunity is formed. Re-infection is virtually impossible.
Treatment and symptoms of chickenpox in children
Chickenpox (chickenpox) is a common childhood infection. Mostly children get sick early age or preschoolers. Susceptibility to the causative agent of chickenpox (the virus that causes chickenpox refers to herpes viruses) is also quite high, although not as high as to the measles virus. About 80% of contact persons who have not been ill before develop chickenpox.
This virus also has a high degree of volatility; a child can become infected if he was not in close proximity to the patient. The incubation period is from 14 to 21 days. The disease begins with the appearance of a rash. Usually it is one or two reddish spots, similar to a mosquito bite. These elements of the rash can be located on any part of the body, but most often they first appear on the stomach or face. Usually the rash spreads very quickly - new elements appear every few minutes or hours. Reddish spots, which at first look like mosquito bites, the next day take the form of bubbles filled with transparent contents. These blisters are very itchy. The rash spreads throughout the body, to the limbs, to the scalp. In severe cases, there are elements of the rash on the mucous membranes - in the mouth, nose, on the conjunctiva of the sclera, genitals, intestines. By the end of the first day of the disease, the general state of health worsens, the body temperature rises (up to 40 degrees C and above). The severity of the condition depends on the number of rashes: with scanty rashes, the disease proceeds easily, the more rashes, the more difficult the child's condition.
For chicken pox, a runny nose and cough are not typical, but if there are elements of the rash on the mucous membranes of the pharynx, nose and on the conjunctiva of the sclera, then pharyngitis, rhinitis and conjunctivitis develop due to the addition of a bacterial infection. Bubbles open in a day or two with the formation of sores, which are covered with crusts. Headache, feeling unwell, fever persist until new rashes appear. This usually happens from 3 to 5 days (depending on the severity of the course of the disease). Within 5-7 days after the last sprinkling, the rash passes. Treatment of chickenpox consists in reducing itching, intoxication and preventing bacterial complications. The elements of the rash must be lubricated with antiseptic solutions (usually an aqueous solution of brilliant green or manganese). Treatment with coloring antiseptics prevents bacterial infection of rashes, allows you to track the dynamics of the appearance of rashes.
It is necessary to monitor the hygiene of the mouth and nose, eyes - you can rinse your mouth with a solution of calendula, the mucous membranes of the nose and mouth also need to be treated with antiseptic solutions.
In order to avoid secondary inflammation, you need to rinse your mouth after each meal. A child with chickenpox should be fed warm semi-liquid food, drink plenty of water (however, this applies to all childhood infections). It is important to ensure that the baby's fingernails are cut short (so that he cannot comb the skin - scratching predisposes to bacterial infection). To prevent infection of rashes, bed linen and clothes of a sick child should be changed daily. The room in which the child is located must be regularly ventilated, making sure that the room is not too hot. These are general rules. Complications of chickenpox include myocarditis - inflammation of the heart muscle, meningitis and meningoencephalitis (inflammation of the meninges, brain substances, inflammation of the kidneys (nephritis). Fortunately, these complications are quite rare. After chickenpox, as well as after all children's infections , immunity develops.Re-infection happens, but very rarely.
What is scarlet fever in children and how to treat it
Scarlet fever is the only childhood infection caused not by viruses, but by bacteria (group A streptococcus). This acute illness transmitted by airborne droplets. Infection through household items (toys, dishes) is also possible. Children of early and preschool age are ill. The most dangerous in terms of infection are patients in the first two to three days of the disease.
Scarlet fever begins very acutely with an increase in body temperature up to 39 degrees C, vomiting. Immediately noted severe intoxication, headache. The most characteristic symptom of scarlet fever is tonsillitis, in which the mucous membrane of the pharynx has a bright red color, swelling is pronounced. sick notes sharp pain when swallowing. There may be a whitish coating on the tongue and tonsils. The tongue subsequently acquires a very characteristic appearance ("crimson") - bright pink and coarsely grained.
By the end of the first-beginning of the second day of illness, the second characteristic symptom of scarlet fever appears - a rash. It appears on several parts of the body at once, being most densely localized in the folds (elbow, inguinal). Her distinctive feature is that the bright red small-pointed scarlatinal rash is located on a red background, which gives the impression of a general confluent redness. When pressed on the skin, a white stripe remains. The rash can be spread all over the body, but there is always a clear (white) area of skin between the upper lip and nose, as well as the chin. Itching is much less pronounced than with chicken pox. The rash lasts up to 2 to 5 days. The manifestations of sore throat persist a little longer (up to 7-9 days).
Scarlet fever is usually treated with antibiotics, because the causative agent of scarlet fever is a microbe that can be removed with antibiotics. Also very important is the local treatment of angina and detoxification (removal of toxins from the body that are formed during the vital activity of microorganisms - for this they give plenty of drink). Vitamins, antipyretics are shown. Scarlet fever also has quite serious complications. Before the use of antibiotics, scarlet fever often ended in the development of rheumatism (an infectious-allergic disease, the basis of which is the defeat of the connective tissue system). with the formation of acquired heart defects. At present, subject to well-prescribed treatment and careful adherence to recommendations, such complications practically do not occur. Scarlet fever affects almost exclusively children because with age a person acquires resistance to streptococci. Those who have been ill also acquire strong immunity.
Infectious erythema in a child
This infectious disease, which is also caused by viruses, is transmitted by airborne droplets. Children from 2 to 12 years old get sick during epidemics in a nursery or at school. The incubation period is different (4-14 days). The disease progresses easily. There is a slight general malaise, discharge from the nose, sometimes a headache, and a slight increase in temperature is possible. The rash begins on the cheekbones in the form of small red, slightly embossed dots, which merge as they increase, forming red shiny and symmetrical spots on the cheeks. Then, within two days, the rash covers the whole body, forming slightly swollen red spots, pale in the center. Combining, they form a rash in the form of garlands or geographical map. The rash disappears in about a week, during the following weeks transient rashes may appear, especially with excitement, physical exertion, exposure to the sun, bathing, changes in ambient temperature.
This disease is not dangerous in all cases. The diagnosis is based on the clinical picture. The differential diagnosis is often made with rubella and measles. Treatment is symptomatic. The prognosis is favorable.
Prevention of infectious diseases in children
Of course, it is better to recover from childhood infections at an early age, because adolescents and older people get sick much more severely with much more frequent complications. However, complications are also observed in young children. And all these complications are quite severe. Before the introduction of vaccination, mortality (mortality) in these infections was about 5-10%. A common feature of all childhood infections is that after the disease develops strong immunity. Their prevention is based on this property - vaccines have been developed that allow the formation of immunological memory, which causes immunity to the causative agents of these infections. Vaccination is carried out at the age of 12 months once. Vaccines have been developed for measles, rubella and mumps. In the Russian version, all these vaccines are administered separately (measles-rubella and mumps). As an alternative, vaccination with an imported vaccine containing all three components is possible. This vaccination is well tolerated, complications and undesirable consequences are extremely rare. Comparative characteristics childhood infections
|
We received several letters with the same request - to give a plate, referring to which parents could diagnose childhood infectious diseases. This, of course, is about the most common ones - such as chicken pox, rubella. All these diseases can be combined even by purely external manifestations - they are accompanied by rash on the skin.
Of course, we are not sorry to give such a sign, if not for some considerations. Well, firstly, we must take into account the ever-increasing number of cases of atypical manifestations of these diseases. And secondly, we must not forget about the so-called differential diagnosis, when doctors say: yes, indeed, this is just such a disease, and not heels similar to it, but requiring a different approach to treatment, other quarantine measures, etc. So this table could serve only as a rough, approximate guide, but nothing more.
For starters, one general rule: any child with any skin rash should be considered potentially dangerous to others as a spreader of a possible infection. This means that you cannot come to the clinic with him for a general appointment and sit in a general queue. The doctor should examine him either at home or in a special box. This will help to avoid many troubles, not so much for the sick person, but for those around him.
Chickenpox in a child
The disease is caused by a virus, and the source of infection can be not only a sick chickenpox, but also a person suffering from herpes zoster - the causative agent here is the same. Chickenpox (or simply chickenpox) is transmitted by airborne droplets. Patients are contagious from the end of the incubation period until the 5th day after the onset of the rash. The incubation, that is, latent, period lasts from 10 to 23 days - in other words, a child cannot get chickenpox before the 10th day after contact with another patient and is unlikely to get sick after the 23rd. This is important: it turns out that a child who has been in contact with a sick person can be in a team until the 10th day without the danger of infecting anyone else.
Mostly children get chicken pox from 2 to 7 years, but in rare cases, newborns and adults can get sick.
The main symptom of the disease is the appearance of a rash consisting of individual spots. Each speck eventually turns into a nodule (papule), the nodule becomes a bubble (vesicle), which bursts, leaving behind a crust. The first rashes (this is important to know!) Usually occur on the scalp, where the doctor tries to detect them.
It would seem that everything is simple: I saw the corresponding element - make a diagnosis. And in 90% of cases, this is exactly what happens. But what about the remaining 10%? Various tricks can lie in wait here. Firstly, the rash can be very profuse, even affecting the mucous membranes, and very sparse, consisting of only a few elements. Usually, new rashes recur within 3-5 days, but it also happens that, having arisen on the first day, the rash no longer appears.
Along with the mildest forms of chicken pox, very severe ones also occur when the blisters fill with blood, become dead, leave behind deep ulcers, and become infected. The rash can appear in the mouth, and on the genitals, and even inside the body - on the inside of the esophagus and intestinal walls. And it's all chicken pox.
It is necessary to differentiate chickenpox with at least six diseases, including insect bites, scabies, strophulus. There can be only one conclusion from all this: they saw suspicious bubbles on the scalp - call the doctor and don’t take such a child anywhere. Chickenpox is extremely contagious.
Measles in a child
Measles now belongs to the so-called controlled infections, that is, those against which vaccination is carried out. This disease is caused by a virus, transmitted by airborne droplets and is accompanied by general intoxication, as well as severe catarrhal symptoms (temperature, rough barking cough,). The rash is predominantly in the form of spots, which sometimes protrude slightly above the skin.
The incubation period usually lasts 9-17 days after contact with the sick person, but if the child was given gamma globulin for the purpose of prevention, it can stretch up to 21 days.
A characteristic sign of measles is that due to damage to the mucous membrane of the eyes, it becomes painful for children to look at the light. One of the main symptoms that help to make a diagnosis is not even a rash, but the appearance on the buccal mucosa opposite the small molars of small whitish spots up to 1.5 mm in diameter surrounded by a red rim. They disappear after two or three days.
On the fourth day of the disease, when the child coughs, sneezes, his face becomes puffy, a rash appears: on the 1st day behind the ears and on the face, on the 2nd day - on the trunk, on the 3rd -on hands and legs. At the same time, the temperature rises again and intoxication increases. At first, the rash is in the form of pink spots, which eventually merge, turn red, become more convex.
The appearance of a measles patient at this time is very typical: the edges of the eyelids are inflamed, blood vessels stand out clearly on the sclera, the nose and upper lip are swollen, and the face is puffy. From the end of the 3rd day, the rash begins to fade in the same order as it appeared, leaving behind pigmentation and scaly peeling.
It would seem that I clearly described the disease, and it would be difficult to confuse it with something else. However, in addition to such typical measles, there is also atypical measles: mitigated measles, measles in vaccinated people and measles in young children.
Mitigated measles occurs when gamma globulin administration, blood or plasma transfusion occurs after the 6th day of the incubation period. This form of the disease proceeds easily, the classical sequence of the appearance and extinction of the rash is violated, the catarrhal phenomena are mild.
Measles in vaccinated people depends on their condition: in its complete absence, a typical course of the disease develops, in the presence of residual antibodies, its mild form.
In children of the first six months of life, measles occurs in cases where the mothers did not have measles, and it is very difficult.
Fortunately, now the most severe forms of this disease are almost never found - hypertoxic and hemorrhagic.
As for the differential diagnosis, here it is quite complicated and includes a range of diseases from the banal to pseudotuberculosis and allergies, including medicinal ones.
Rubella in children
They began to talk a lot about this not at all serious viral disease due to the fact that its connection with the appearance of congenital malformations in the fetus was established - this infection is most dangerous for women in. The issue of vaccinating girls against rubella has now been practically resolved.
The disease is manifested by an increase in the occipital and posterior cervical lymph nodes and a small-spotted rash on the skin. I draw your attention - the main thing here is the enlargement of the lymph nodes, on this basis, doctors make a diagnosis.
The source of infection is a sick person, who is dangerous from the end of the incubation period to the 5th, and sometimes up to the 10-15th day of illness. With congenital rubella, the virus remains in the body for up to 2 years. The infection is transmitted by airborne droplets. After an infection, a strong immunity remains.
The incubation period is from 11 to 22 days. As I said, the first symptom is an increase in the posterior cervical and occipital lymph nodes, which sometimes reach 10-15 mm in diameter and remain enlarged for up to 10-14 days. Sometimes these symptoms are mild, and the diagnosis is made only after the discovery of a small-spotted rash, individual spots of which do not merge and disappear without a trace on 2-3 days from the onset of the rash. Rubella is characterized by a thickening of the rash on the extensor surfaces, but it should be remembered that in about a third (!) Of cases, the disease can proceed without a rash at all, so lymphadenitis remains the main and most important sign of rubella.
This disease is differentiated with mitigated measles, and with scarlet fever, and with. So it's not so easy here either.
Mumps (mumps) in a child
If rubella is potentially dangerous for pregnant women and girls should be vaccinated against it, then mumps is dangerous for boys: 25% of everything comes from the consequences of orchitis - inflammation of the testicles. Mumps is also a vaccine-preventable disease, and has been vaccinated against it for several years.
The disease is caused by a virus that affects the parotid glands, other glandular organs and the central nervous system. The source of the disease is a sick person from the end of the incubation period to the 10th day from the onset of the disease. Epidemic parotitis is transmitted by airborne droplets. 95% of the patients are children from one to 15 years old.
How does the disease begin? The temperature rises, the child complains of pain when opening the mouth and when chewing solid food. By the end of the first day, the parotid gland increases on one or both sides. Dryness appears in the mouth, ear pain may appear.
When examining the oral cavity, the doctor reveals swelling and redness around the salivary duct. Both the submandibular salivary glands and the sublingual glands may be involved in the process. Often there is damage to the pancreas. There may be defeats from nervous system- encephalitis. And although these complications are very rare, it’s still not worth tempting fate - it’s best to vaccinate a child against mumps and not think about the possibility of such formidable complications as deafness or testicular atrophy.
Is it always easy to diagnose mumps? No not always. It is necessary to differentiate this disease with submandibular lymphadenitis, and with a purulent lesion of the parotid gland, and with salivary stone disease, and with a number of other diseases. The vaccinated may have an erased form of mumps.
Scarlet fever in a child
Scarlet fever is a disease caused by group A beta-hemolytic streptococcus. It is characterized by intoxication, tonsillitis with cervical lymphadenitis and punctate rash. The source of infection are patients with scarlet fever, tonsillitis, streptococcal nasopharyngitis and even healthy carriers of streptococcus.
The infection is transmitted both by airborne droplets and through infected things and food. Scarlet fever, unlike previous infections, can be ill again. There are no vaccines against her.
In a typical case, the disease begins acutely, with fever up to 38-40 ° C, vomiting, and the appearance of a sore throat when swallowing. Changes in the pharynx on the first day are small, which does not at all correspond to the degree of painful intoxication.
By the end of the first day or on the second, a small punctate rash appears on the skin at once with thickening in the inguinal and elbow folds, popliteal and axillary fossae, on internal surfaces shoulders, lateral surfaces of the chest and on the abdomen. The rash is small, profuse, pink-red. The skin is dry, rough, in many patients a pale nasolabial triangle is noticeable against the background of reddened cheeks. The fragility of the vessels is increased, which manifests itself when trying to measure or when examining the injection sites - more bruising is visible there than usual.
The rash can last from a few hours to 6-7 days. Depending on the severity of the disease, peeling of the skin begins in the first or second week: on the neck, earlobes and trunk - pityriasis, on the palms and feet - lamellar.
Changes in the pharynx, the state of the lymph nodes and tongue help to make a diagnosis. Zev bright, very red, flaming, redness sharply defined. Mandatory tonsillitis - without raids or with raids (in severe scarlet fever, even necrotic). Lymph nodes at the angle of the jaw are enlarged, dense and painful. The tongue is densely covered with white coating, from the second day it begins to clear from the edges and has a crimson hue, which persists until the 11-12th day of illness.
Scarlet fever is one of the brightest diseases, but difficulties in diagnosis lie in wait here.
First, there are several atypical forms that do not depend on the defeat of the pharynx. These are wound, burn, postpartum forms of scarlet fever. There are mild forms in which the rash is ephemeral, and the changes in the pharynx are negligible, and the diagnosis is already made on the basis of skin peeling. Scarlet fever has to be differentiated from pseudotuberculosis, prickly heat, throat diphtheria, rubella, measles, drug allergies and a number of other diseases. So here, in some cases, it is not possible to get by with a short description, but considerable experience is needed as a pediatrician and infectious disease specialist.
There are a number of specific tests that can clarify the diagnosis in difficult cases, in particular, the determination of antibodies. Therefore, I can only advise one thing: if an infection is suspected - put the child to bed, isolate it from others if possible and call a doctor. Only he can take responsibility for the final diagnosis.
Skin rashes appear as a sudden phenomenon on the skin in any area of the body. The rash is characterized by skin changes, redness or blanching, and itching. A symptom can form as a local reaction to external provoking factors, or it can manifest itself as a sign of the development of a pathological process. There are quite a lot of diseases that manifest themselves in the form of skin rashes, therefore the etiology of the symptom is diverse.
Etiology
Rashes on the skin in adults and in a child can be formed under the influence of such factors:
- infections;
- allergy;
- disease of the blood and blood vessels.
The most common cause of the appearance of a symptom is an infectious infection. Doctors refer to such diseases -, etc. These diseases manifest themselves in a characteristic rash, which is accompanied by, in the head, throat and abdomen, and a violation of the stool.
Allergic skin rashes are also often diagnosed by doctors. This form of symptom development can be recognized by the absence of signs of infection, as well as contact with the allergen. Very often, a similar reaction on the body can be noticed by the parents of the child. Provoking factors are food, animals, chemical substances, drugs.
In case of violation of blood circulation and vascular disease, the patient may experience a rash for such reasons:
- decrease in the number or impaired functionality of platelets;
- impaired vascular permeability.
Sometimes a symptom develops in non-communicable diseases, these include:
- senile keratoma;
- chloasma;
- flat warts;
- intertrigo;
Rashes on the skin are formed with liver disease. If the organ malfunctions, the patient's skin tone changes, and a rash appears.
Characteristic red rashes can be from insect bites, acne, psoriasis, fungal diseases and scabies. Also, redness on the skin can be caused by prickly heat.
Classification
Clinicians have determined that the types of rashes can be such manifestations:
- spots - there are red, brown, white maculae;
- blisters - appear in a dense and rough formation on the skin;
- papules - an element that looks like nodules in the thickness of the skin;
- bubbles - they can be large and small, are formed in the cavity of the skin with a clear liquid;
- erosion and ulcers - during the formation, the integrity of the skin is violated;
- crusts - appear on the site of former blisters, pustules, ulcers.
All listed species rashes on the body are divided into primary and secondary. The first type includes nodules, blisters, abscesses, blisters. And the second group of varieties of rash is the appearance of peeling, erosion, abrasions, crusts.
Symptoms
If skin rashes in children and adults have formed against the background of a deterioration in the functioning of the liver, then characteristic symptoms may indicate this:
- yellow tint of the skin;
- fetid smell;
- strong sweating;
- pain in the liver area;
- itchy rashes on the body;
- sharp weight loss;
- broken stool;
- Brown color language;
- bitter taste in the mouth;
- the appearance of cracks in the tongue;
- venous pattern on the abdomen.
If the cause was infectious diseases, then a person's skin rashes can begin on the skin of the hands, move to the face, legs, and the whole body is gradually affected. With rubella, the patient first overcomes the rash on the face and spreads throughout the skin. The first foci of inflammation are localized in places where the surface of the limbs most often bends, near the joints, on the back and buttocks. All rashes can be different shade- pink, red, pale, brown.
Infectious pathologies often manifest themselves not only in a rash, but also in other signs. You can establish the disease in more detail according to the following clinical picture:
- elevated temperature;
- malaise;
- pain attacks;
- certain areas on the patient's body become inflamed, for example, eyes, tonsils, etc.;
- May be ;
- frequent heartbeat;
- burning.
Rashes on the skin in the form of red spots are characteristic of the development of such infectious diseases - chickenpox, rubella, measles, scarlet fever.
Diagnostics
If any manifestations of the above symptoms are detected, the patient should urgently seek the help of a doctor. You can consult about rashes on the skin at,. After an initial physical examination and a minimal examination, the doctor refers the patient to another specialist if the cause of the disease is not inflammation, allergies or infection.
Treatment
Treatment of allergic skin rashes is prescribed by the doctor only after the diagnosis has been made. Therapy is based on the elimination of the etiological factor, therefore, appropriate drugs must be selected.
If a person has a rash from mechanical damage or from prickly heat, then there is nothing wrong with such a manifestation. At home, you can anoint the inflamed area with cream or oil to slightly relieve swelling and itching. Over time, the symptom will disappear. Also at home, you can eliminate the symptoms of the disease with such advice from doctors:
- wear things made of natural cotton so that there is no irritation;
- wash the body with baby soap or shower gel;
- exclude from life all things that can cause a rash on the skin.
If the symptoms are more pronounced in the patient, have characteristic indicators, cause discomfort to the patient, then a consultation with a dermatologist is necessary.
If the appearance of the disease was an allergy, then it is important for the doctor to identify this allergen with the help of a sample, and then prescribe treatment. The patient must definitely move away from this item or remove the product from the diet. You can also cure such a symptom with antihistamine ointments and tablets.
If outward sign, namely the rash, developed from the virus, and the symptoms of the disease are supplemented by fever, then the patient can be given antipyretic drugs. In case of complications of the disease, antibiotics and anti-inflammatory drugs are prescribed.
Quite often, skin rashes in diabetes mellitus, liver disease, infectious diseases or allergies are not very easy to recognize by doctors, since the symptom often manifests itself in the same indicators - itching, redness, swelling. In this regard, physicians first prescribe to the patient therapy, which is aimed at getting rid of the signs, and not the causes of the development of the disease.
