Common Childhood Diseases

COMMON COLD OR UPPER RESPIRATORY INFECTION
Colds are very common in young children, because they have not acquired immunity to the viruses that cause them. Symptoms may include any or all the following: a runny nose, sneezing, nasal stuffiness, fever, a dry cough, fatigue, a sore throat, red eyes and a loss of appetite. The incubation period is generally 1 to 4 days, and the duration is about 3 to 10 days. Treatment is purely symptomatic. See under common symptoms for details on how to approach each individual symptom.
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BRONCHIOLITIS
This is often serious viral infection of the small airways in the lungs. The respiratory syncytial or parainfluenza viruses usually cause it, most commonly in children less than 2 years old particularly in those younger than 6 months. The illness begins with mild cold symptoms followed in a few days by rapid, labored breathing, wheezing and low grade fever. If your child seems to have these symptoms, contact his doctor at once or go to the nearest emergency room. He may need to be hospitalized and started on anti-viral treatment.
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BRONCHITIS
This infection causes the inflammation of the bronchial tree and often the trachea (windpipe). It may be caused by numerous viral, bacterial or mycoplsmal organisms. Children under 4 years old are most susceptible. Generally, it begins with cold symptoms, followed by the abrupt appearance of fever (often greater than 102 degrees Fahrenheit), a harsh cough productive of green or yellow sputum an din many cases, wheezing. If it lasts more than 3 days or if your child appears particularly ill, he may need to be started on antibiotics. Meanwhile, increasing his fluids and putting him under a cool moist vaporizer may be of help. Try to keep the fever down and treat the couch, especially if it is severe enough to cause vomiting.
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CHICKEN POX (VARICELLA)
This infection occurs most commonly in the late winter or spring and appears in community outbreaks. Most people have the disease in their childhood, and this imparts immunity for a life time. A mild fever, malaise, headache and sore throat may herald the appearance of the characteristic rash. The rash begins as flat red spots that turn into pimples and the blisters. These blisters soon crust over. New crops of spots appear fore but 3 days and include the scalp, gums, mouth and vagina along with the rest of the body. Itching is the most annoying symptom, so be sure to review its treatment in the Common Symptoms section. Your child should be isolated from those who have no history of the disease until he is no longer contagious. This takes place when all the blisters are crusted over and no new ones are erupting. The scabs last about 5 to 20 days. DO NOT GIVE ASPIRIN.
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CONJUNCTIVITIS
This is an infection of the conjunctiva or lining of the eye (also known as “pinkeye”) which causes tearing, burning, itching, redness and light sensitivity of the affected eye. It usually spreads to the other eye very rapidly. If your child has this, cold eye compresses may help, but be sure to separate his washcloth from those of the rest of the household to prevent spread of the infection to others. It can be caused by many infectious agents and even by allergies or chemical irritants, but if the etiology appears to be bacterial or viral, he may need to start on some special eye drops as prescribed by his doctor.
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CROUP
This infection (also known as laryngotracheitis) generally occurs in young children. It commonly occurs in the middle of the night and is characterized by a barking or crowing type cough and a granting sound on inhalation. Steam inhalation is highly effective, but if this fails, if your child’s color appears blue, if he is drooling excessively or if you suspect he is choking on something, contact his doctor at once.
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EAR INFECTIONSExternal Ear (“Swimmer’s ear or Otitis external)
An infection of the external ear affects the skin of the ear canal that starts at the ear drum and ends at the opening of outside. This ailment is very common in children that play a lot in warm water, because the moisture encourages the growth of fungi and bacteria. Symptoms range from mild itching to pain and a yellowish to greenish discharge of pus from the ear. If your child has ear pain, you can help differentiate swimmer’s ear from a middle ear infection by tugging on the ear. If this causes a significant increase in his pain, it is probably swimmer’s ear. In a middle ear infection, tugging in the ear would typically not alter the pain intensity. Treatment consists of special drops prescribed by your child’s doctor. If the recurrences are frequent, try to limit your child’s exposure to water to no more than an hour, and use a towel to dry the opening of the ear after gently shaking the water out of the canal. His doctor may suggest that you put acetic acid or alcohol drops into his ears after swimming as a preventative measure.
Middle Ear (Otitis Media)
Pain, irritability, fever and loss of appetite usually accompany an infection in the middle ear. It commonly appears after a cold or flu, because the residual fluid left in the Eustachian tube behind the tympanic membrane (eardrum) acts as a perfect culture media for different infectious agents. It usually responds well to antibiotics, but for immediate soothing measures, a heating pad on a low setting held against the ear, analgesic ear drops, a decongestant and appropriate dose of acetaminophen may be warranted. If several attempts of antibiotics fail or if the infection recurs extremely frequently over a 8 to 12 month period, tiny drainage tubes may need to be inserted under general anesthesia as a last resort. These tubes usually fall out on their own in 9 to 12 months. If chronic allergies appear to cause the recurrent bouts of ear infections, controlling or eliminating them may solve the problem.
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EPIGLOTTITIS
This is the infection of the epiglottises, which separates the opening of the esophagus from the windpipe. It occurs most commonly in the winter and is uncommon in children younger than two. The child will have a low-pitched cough, a muffled voice, fever, a glassy, droopy looking stare, trouble swallowing and breathing, and excessive drooling. He may also have a protruding tongue, It is usually caused by the bacteria Hemophilus Influenza B. If you suspect your child has this, call 911 or go to the ER immediately. Do not put anything in his mouth, as this can cause complete and sudden obstruction of the upper airway. Keep him upright and leaning forward. Treatment consists of antibiotics in a hospital setting.
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FIFTH DISEASE (ERYTHEMA INFECTIOSUM)
This disease usually occurs in the early spring, commonly in community outbreaks in children between 2 and 12 years old. It begins as a bright red rash on the face, which gives the characteristic “slapped cheeks” look. This is followed the next day by a similar but less intense rash on the arms and legs and then 3 days later by a rash on other parts of the body. It can last anywhere from 3 days to 3 weeks and can be accompanied by mild joint pain. The causative agent is thought to be the human parvovirus. It requires no treatment, but because of its contagious nature, your child will not be allowed to return to school until the rash is gone.
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GERMAN MEASLES (RUBELLA)
This disease is caused by the Rubella virus and appears most commonly in late winter and early spring. The affected person may have fever, swollen neck glands, headache runny nose and small, flat pink spots on the skin. These appear first on the face and later spread to the rest of the body, as well as occasionally on roof of the mouth. It lasts up to 5 days and requires no treatment. Precaution should be taken to avoid unimmunized pregnant women, because if the virus is transmitted to the fetus, severe complications can occur. The infection imparts immunity for a lifetime.
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HERPES SIMPLEX (FEVER BLISTERS)
Sunlight, emotional stress or another infectious disease can precipitate this infection. It can also occur spontaneously. First time infections can be accompanied by fever, malaise, sore throat, swollen glands bad breath, drooling or loss of appetite. Subsequent flare-ups can occur alone or with mild headache. Outbreaks last about a week. Occasionally, infections may involve the conjunctiva (see Conjunctivitis). If this is a case, evaluation by an ophthalmologist is advised. Otherwise, medical attention need not be sought unless your child appears ill. Antiviral medication both orally and topically is available but is usually reserved for moderate severe cases.
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HIVES AND ECZEMA
Hive is raised and itchy rash that can be caused by allergies to food, medicines and other allergens, stress, cold temperatures, sunlight and pressure against the skin. Usually the exact cause is not found, and the symptoms are simply treated. There may be swelling of the lips, eyelids and tongue and, in some cases, the larynx or vocal cords. The latter can result in considerable respiratory distress. Mild cases respond well to treatment listed under “itching” in the Common symptoms section. Some cases require treatment with antihistamines prescribed by your doctor, and recurrent cases may require a consultation with an allergist.
Eczema is a skin condition that has an allergic etiology. It is often familial and is most common in the first two years of life. A scaly rash may appear on the face, the folds of the arms or the backs of the knees. Although these are the most common areas of involvement, the rash can occur anywhere. Topical cortisone creams can be of great value in most cases, but should never be used without the approval of the doctor.
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IMPETIGO
Impetigo is a bacterial infection of the skin common in children and most frequent in summer. It begins as a small red bump that oozes a thin yellow liquid. Then, the discharge dries to a light honey-colored crust. Impetigo is considered contagious, so your child’s washcloth and towel should be clearly separated from those of the rest of the family. You can apply warm, wet soaks to the affected area, followed by a triple antibiotic ointment like Bacitracin or Neosporin. If the case is severe, his doctor may prescribe a course of antibiotics to be taken by mouth.
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INFLUENZA
Influenza generally occurs in the winter months. Symptoms can include the abrupt onset of fever, malaise, a dry non-productive cough, diarrhea, vomiting and itchiness. The worst of the symptoms usually subside in 1-2 days, but the illness may not be totally over for 1 to 2 weeks. Call your child’s doctor if he is younger than 6 months, if the symptoms continue to be severe after 72 hours or if the fever is greater than 102 degrees Fahrenheit. Treatment is symptomatic, but if your child’s case is severe, an anti-viral medication may be prescribed.  DO NOT GIVE ASPIRIN.
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LICE
These small insects do a lot to unnerve the parents of small children. They are very common in kids attending nursery school and kindergarten and are spread easily from child to child. The earliest symptom is mild scalp itching. Many times, the lice, their eggs or both are readily visible to the naked eye. If your child has lice, his doctor will prescribe a special shampoo that is usually curative with one application.
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MEASLES (RUBEOLA)
This disease occurs most commonly in the winter and spring and always in people who are not immunized. For the first couple of days, your child may have fever, a runny nose, red and watery eyes and dry couch. Tiny white spots known as “Koplik spots” may appear on the inside of the cheeks. These often bleed when lightly scraped with a tongue depressor. A red, slightly raised rash begins on the forehead and behind the ears and then spreads downward to the rest of the body. The disease lasts about one week and requires only symptomatic treatment. Possible complications include pneumonia, convulsions, encephalitis and otis media (middle ear infection).
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MENINGITIS
This disease is an inflammation of the lining around the brain and spinal cord caused by various viral and bacterial agents. One of the common bacterial agents is Hemophilus Influenza B. Symptoms include fever, a stiff neck and headache (in older children), a high pitched cry (in infants), drowsiness, vomiting, light sensitivity (in older children), irritability and various neurological signs and symptoms. If you suspect that your child has this illness, you should call his doctor immediately. For viral meningitis, the treatment is purely symptomatic, but for bacterial meningitis, hospitalization and 1V antibiotics will be necessary. The exact etiologic agent is determined by a lumber puncture (spinal tap). With this procedure, a spinal needle is inserts between two of the lower vertebrae through an area of anaesthetized skin, and once in the space between the spinal cord and its lining, spinal fluid is withdrawn for cultures and other studies.
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MUMPS
Mumps is a viral infection of the salivary glands that occurs most frequently in the winter and spring. Anyone without prior immunity is susceptible. Although 30% have no symptoms at all, most have fever, swelling of the parotid salivary glands below and in front of the ear, a loss of appetite, ear pain and pain on chewing. The entire course lasts about 5 to 7 days. Symptom relief includes the application for cool compress to the swollen salivary glands and fever treatment. You should contact your child’s doctor if he has any signs of meningitis (see above), because although rare, this is one of the serious complications possible. Orchitis (a testicular inflammation) and oophoritis (an ovaries inflammation) can occur as a serious complication of mumps. This can sometimes lead to sterility, but not commonly.
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NONSPECIFIC VIRAL ILLNESS
This is a common illness of young children, particularly in the summer. The range of symptoms can vary widely, and can include a loss of appetite, nausea, vomiting diarrhea, a variety of rashes, and fever. Treatment is purely symptomatic and the infection lasts for only few days. Be sure you confirm the diagnosis with your child’s doctor and keep him or her informed of any worsening of his condition or of the appearance of new symptoms.
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PERTUSSIS (WHOOPING COUGH)
This ailment generally appears in late winter or early fall. Half of all cases occur in children younger than one year. Symptoms follow three discrete stages beginning with the “catarrhal stage”. In this stage, there are cold symptoms, fever and irritability. The second or “paroxysmal stage” is characterized by explosive paroxyms of coughing productive of very thick sputum. The third and final “convalescent stage ” is characterized by a gradual improvement in all of the existing symptoms. The entire process lasts about four to six weeks. Complications include ear infections, pneumonia, convulsions and even death. The pertussis component of the DTP vaccine gives protection for most recipients, but the few that are immunized and contract the disease anyway have a much shorter and milder course. Treatment consists of fluids, symptom relief and antibiotics. Infants are generally treated in a hospital setting.
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PINWORMS
This is a common worm infestation in children and is spread when they touch contaminated objects and then put their fingers into the mouth. Your first clue may be your child’s complaints of anal itching at night. Girls sometimes complain of painful urination. Diagnosis is confirmed both by visualizing the small white worms around the anus at night and by taking a pinworm smear in the doctor’s office. Here, before your child has taken a bath for the day, a small clear paddle with a sticky surface is pressed firmly against the anus. It is then placed under a microscope to search for the characteristically shaped pinworm eggs. If the diagnosis is confirmed, each member of the household (except pregnant women and very small infants) are given one dose of an anti-parasitic medication to cure both symptomatic and asymptomatic cases. The bed linens and dirty clothing should be washed as well.
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PNEUMONIA
Pneumonia has a long list of possible causative agents including various viruses, bacteria fungi, mycoplasma and other organisms. It occurs in all age groups, but is most frequent in the old, the very young and those with underlying chronic medical problems. It commonly occurs as an aftermath to other infectious processes like colds and flues. Symptoms can include fever productive cough, rapid breathing, wheezing, chest pain made worse by inspiration and sometimes, abdominal pain. With the advent of powerful and safe antibiotics, most cases of pneumonia are treated at home. Viral pneumonia doesn’t respond to antibiotics and is treated from a symptom relief standpoint only. Those children with significant respiratory distress, an unacceptably slow response to treatment or an underlying potentially dangerous disease like asthma, diabetes, sickle cell anemia, etc., may be hospitalized right away. The duration of the disease varies widely, depending on the causative organisms and other factors.
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RINGWORM
Ringworm is a very common fungal infection that is spread between children and from certain animals Like cats) to children. Itchy, scaly patches with red circular borders occur most typically in the scalp but can be seen anywhere else in the body. Anti-fungal creams, both over-the-counter and by prescription, are highly effective once the diagnosis is confirmed by the doctor.
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ROSEOLA INFANTUM
This illness is common in babies and younger children. It can occur year-round, but peaks in the spring and fall. Most believe a virus causes it, but the exact mechanism has yet to be confirmed, and the mode of transmission is still unknown. Symptoms last about 3 to 6 days and include fever, irritability, loss of appetite and a rash consisting of faint pink spots on the body, neck, and upper arms and sometimes the face and legs. This rash characteristically fades to white with pressure. Some children get a runny nose, convulsions and swollen glands. After the doctor has confirmed the diagnosis, treatment is targeted toward symptom relief.
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SCABIES
Scabies is a skin condition caused by a tiny mite that burrows itself under the skin and lays eggs. It causes a very itchy, raised linear rash that is seen most frequently between the fingers and toes, around the nipples and armpits and on the inner surfaces of the wrists. This itching is usually itchy at night. If your child has this condition, his doctor will probably give him a liquid medicine to apply from his chin to his toes at bedtime usually for one but occasionally for two conservative nights. You will then be asked to clean all dirty bed linens and clothing and wash the medicine off well with soap and water the next morning.
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SCARLET FEVER
The streptococcus bacteria cause this ailment. It is most common in the colder months. It occurs chiefly in school-age children and less so in toddlers and adults. The symptoms are similar to those of strep throat (see below) but some have vomiting in the initial days of the illness. There is also a bright red rash, which starts on the face (sparing the area around the mouth), in the groin and under the arms and spreads to the rest of the body. This rash eventually leaves the skin rough peeling. The bulk of the symptoms lasts 1to 2 weeks. Treatment is essentially the same as for strep throat.
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SORE THROAT (STREP)
This infection occurs mostly in school-age children between the months of October and April. Symptoms can include fever (often high and with a sudden and rapid onset), a red, pus-covered pharynx (back of the throat), a headache, a loss of appetite, abdominal pain and swollen tonsils and neck glands. Older children usually have more severe symptoms than younger children and infants. The diagnosis can be quickly confirmed with a five-minute strep screen in the doctor’s office. Treatment includes antibiotics and symptom relief. The illness lasts 1 to 2 weeks and usually responds quickly to relatively mild and inexpensive antibiotics. Complications can include peri-tonsilar abscesses, a spread of the infection to the ears, lungs, brain, kidney, sinuses and skin, and although uncommon, rheumatic fever.
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SORE THROAT (VIRAL)
This illness is common throughout the school year months. It affects mostly older children. Symptoms include moderate fever, joint and muscle aches, sore throat, hoarseness, and occasionally coughing. The back of the throat appears red and the tonsils swollen. These symptoms usually last anywhere from 1 to 10 days and treatment consists of relief only. A strep screen or throat culture should be done to rule out strep throat. DO NOT GIVE ASPIRIN.
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STYE (VIRAL)
A stye is a bacterial infection of the area around the sweat glands or the hair follicles at the edge of the eyelid. It causes red, swollen lump at the lid edge that often oozes pus. A chalazion is a swollen oil gland on the undersurface of the lid that may or may not be infected. It appears as a lump under the lid. If your child has either of these, warm wet compresses held to the eyelid for 20 to 30 minutes 3 to 4 times a day will usually take care of it. Some infections require a prescription of special antibiotic ointment or drops designed for the eye! Recurrent chalazions occasionally need to be removed surgically, but this is uncommon.
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THRUSH (ORAL)
Oral thrush is a yeast infection involving the mouth. It appears as whitish patches on the lips, tongue, palate, gums, and cheeks that can not be removed by scraping. Many babies have no symptoms, but some are bothered by soreness and feed poorly if at all. Thrush is more common in infants that recently been on antibiotics. It can be treated with an oral medication prescribed by your child’s doctor. In its non-oral form, thrush can appear in the diaper area.
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TONSILLITIS
See Sore Throat, both strep and viral.