When Sweetie was carried into the pediatric clinic by my mother for 8 months, there was no crying and uneasiness that I was accustomed to, and there was no obvious physical discomfort, just two small eyes open, curiously looking at me and everything in the clinic. Bao Mom opened her mouth slightly anxiously: "Doctor, our baby suddenly had a fever last night without knowing what was going on, 39 ° C, took antipyretic drugs to come down." Now it's not burning, and it's okay to eat, drink, and have fun. I'm afraid she'll have another fever tonight, what do you think? What the hell is wrong with your baby? ”
While carefully inquiring about the specific incidence of the baby's child, I began to examine the baby's body. It turned out that this little baby had been in good health since birth, and this was the first time he had been sick. In addition to fever, the baby has no other physical discomfort. There are no common related symptoms such as cough, runny nose, diarrhea, vomiting, rashes, etc., but fatigue and fatigue at the time of fever, and it returns to normal after the fever. The examination of the body is only slightly hyperemia of the pharynx, and no other obvious physical abnormalities are found. Then I arranged a blood routine and C-reactive protein test for the baby, and the results were within the normal range.
The initial judgment is that the child is a viral infection of the upper respiratory tract, which is commonly referred to as a "cold". I further explained to Bao Mama: the general viral infection, the site of the upper respiratory tract, the symptoms are mild, usually after a few days can heal themselves, do not need anti-infection treatment, that is, do not use anti-inflammatory drugs. Babies only have fever, generally in good physical condition, you can temporarily do not take medicine. Drink plenty of water, only in high fever, body temperature exceeds 38.5 ° C, give antipyretic agent can be. In the next few days, in addition to the daily care of the baby, the mother needs to observe whether the baby will have high fever convulsions, irritability, drowsiness, poor spirits, cough, runny nose, diarrhea, vomiting, rashes and other symptoms, if there is, or there is still fever after 3 days, it is necessary to go to the hospital for follow-up in time. After hearing this, Bao Mom gladly accepted it and took the baby away.
After 4 days, I saw Sweet Baby again. Obviously, Bao Mom was very anxious this time, and as soon as she entered the consultation room, she anxiously described the baby's condition: after the last visit, the baby still had a fever, and the fever was higher and higher, and twice even reached more than 40 ° C, and it was slightly thinner. The night before, the baby was hot again, and he was restless, crying, difficult to soothe, and the family was very worried, and rushed to the hospital early in the morning. After the whole body examination, I found that the baby's body temperature has dropped to normal, in addition to the obvious congestion of the pharynx, the posterior occipital lymph nodes can also be touched, and the face and neck, anterior chest, and back skin can see a red millet-like rash, and the skin color in the middle of the rash is normal. Asking Mom again when the child had a rash, Mom said she only saw it when I examined the baby. A review of the blood count shows that the white blood cell count is lower than the previous one, and the lymphocyte percentage and count are significantly increased. The diagnosis is clear as an acute rash in young children. Your baby's condition will get better quickly and you won't need much intervention.
Infantile rash, also known as infantile roseola, is mainly a rash fever in infancy and childhood caused by human herpesvirus infection. Spread by droplets and contact, there are no significant seasonal differences in epidemics, no sex differences. However, there are unique characteristics of the age of onset, 6 to 18 months of age children are more common, rare after 3 years of age, the disease of children can recover smoothly, after the disease can obtain lasting immunity. Acute rash in young children is characterized by acute onset, high fever duration, generally 3-5 days, fever regresses, rash is characterized by red maculopapular rash, rash order from head to toe, the degree of severity is different. There are more rashes on the trunk, waist, and buttocks, and there are fewer distributions of the face, elbows, and knee joints. The rash resolves after 1 to 2 days, and there is no desquamation and pigmentation after the rash recedes. Blood count: the total number of peripheral blood leukocytes is low, and lymphocytes are elevated. Attention to distinguish between high fever and cold before the rash: colds are less likely to appear continuous high fever, and cough, runny nose and other symptoms are more obvious; attention is distinguished from measles in the rash phase: the measles eruption period is mostly around the 4th day of the high fever period, and there is still high fever after the rash, the oral mucosa can see measles mucosal spots, and the rash is accompanied by desquamation.
(Source: Tencent Medical Code)
In this way, according to the development process and rash characteristics of Sweet Sweet, it is not difficult for us to come up with the diagnosis of acute rash in young children.
So, how to care for your child during the high fever period that is difficult to endure before the rash? First of all, active physical cooling, physical cooling can be given cold compresses or warm baths, fever more than 38.5 ° C children, given oral acetaminophen or ibuprofen cooling, for children who have a history of hyperthermia convulsions before, special emphasis is placed on timely and effective cooling. Depyretic agents can be administered at body temperatures above 38.0 ° C to prevent the occurrence of hyperthermic convulsions. Once there is a high-fever convulsion, the scene can be immediately acupressed in the person; the head is turned sideways to prevent vomit from being inhaled into the trachea by mistake; and the nearest medical treatment is sedation and anticonvulsant symptomatic treatment. The prognosis of acute rash in young children is generally good, as long as the child's mental state is good, feeding and playing are normal, and can be observed at home. However, when children have high fever convulsions, irritability, drowsiness, and poor spirits, they should go to the hospital in time.
After another 2 days, I called to follow up sweet's condition, and my mother happily reported: after the second visit, the baby did not have a fever again, and the rash on the body disappeared without a trace within 3 days, and now the baby has recovered as before. While I am happy for the baby's recovery, I also appreciate the performance of the mother when the baby is high in fever: although the heart is tormented, she can still follow the doctor's advice and avoid the excessive application of drugs.
Among the common upper respiratory tract infections in children, most are viral infections with a good prognosis, as long as the antipyretic symptomatic treatment does not require the use of anti-infective drugs. Anti-infective drugs are usually divided into antibacterial drugs and antiviral drugs. Antibacterial drugs are ineffective against viral infections, while antiviral drugs are usually only used to identify severe infections that are the type of viral infection, and general viral infections are not recommended. However, some parents see that their children have fever, they are anxious and helpless, thinking that if the doctor does not give anti-inflammatory drugs, it is equivalent to not giving effective treatment, and it is uncomfortable to watch the child. This is a common misconception. Antibiotics are a double-edged sword, used properly can effectively kill pathogenic microorganisms that invade the human body; improper use will destroy the body's immune balance, resulting in microflora disorders and pathogen resistance in the body, affecting long-term physical health. When to use antibiotics, when not to use, or let professional doctors help parents grasp it.