(Disclaimer: This article is for general science purposes only, and the information in the following content has been processed to protect patient privacy)
Abstract: A 1-year-old baby presented with a high fever of 39.5℃ without convulsions and other accompanying symptoms, and the temperature increased repeatedly after taking medication to reduce the fever, along with diarrhea, presenting yellow watery stools about 5 times a day. The rash appeared immediately after the fever subsided, but otherwise there were no other uncomfortable symptoms. It is considered to be a clinical symptom of early childhood rash, which is due to viral infection and has a certain self-limiting nature.
Basic information】Female, 1 year old
Disease Type】Emergency rash
Hospital】Wuhan University Central South Hospital
Date of Consultation】August 2019
Treatment plan】Medication (ibuprofen suspension, oral rehydration salt dispersion (III), montelukast)
Treatment period】1 week of standard treatment
【Treatment effect】The baby’s body temperature returned to normal, the rash subsided, diarrhea symptoms disappeared, and returned to a healthy state
I. Initial consultation
When the family brought the 1-year-old female baby to the clinic, the family told her that the baby had high fever 3 days ago, with a temperature of 39.5℃, but no convulsions, along with yellow watery stools about 5 times a day, and the baby was crying and not easy to coax. After using antipyretic drugs at home, the baby’s temperature could drop for a short period of time, but soon rose again, so he came to the hospital to seek specific causes and treatment accordingly. The baby was observed to be in good spirits and no skin rash was seen. After examination, we found no bulging fontanelle, coarse breath sounds in both lungs on auscultation, no wet rales, and active intestinal sounds. We considered that it might be caused by the baby’s emergency rash and suggested hospitalization for further examination.
II. Treatment
First, the baby was examined for routine blood, liver and kidney functions, and stool routine. The routine blood tests showed that the white blood cell count was 10×10^9/L, the neutrophil percentage was 29.7%, and the lymphocyte percentage was 62.2%, which was considered to be a viral infection causing the baby’s acute rash. After admission, the baby still had symptoms of recurrent high fever, so he was given ibuprofen suspension to reduce fever. Since the baby also had diarrhea, he was given montelukast to stop diarrhea and prevent frequent diarrhea from causing water-electrolyte disorders, and oral rehydration salts (III) to prevent dehydration. After 3 days of hospitalization, the fever subsided and the diarrhea subsided, and a red papule gradually appeared on the baby’s skin.
Treatment effect
The baby’s symptoms could be improved significantly after hospitalization. After 3 days of medication, the high fever temperature subsided and diarrhea symptoms were relieved, but then a red rash appeared all over the body, which was flat and not accompanied by itching, and the baby showed symptoms such as irritability. After 1 week of hospitalization, the baby’s skin rash subsides, fever, diarrhea and other symptoms disappear completely, at this time, observe the baby’s mental activity, no crying and other phenomena, indicating that the condition has reached clinical cure, permission to discharge.
IV. Notes
We are glad that our baby was treated in a timely manner. We need to remind parents that they should take their babies to play outdoor sports and get fresh air on a daily basis, because E.R. is contagious, so they need to do a good job of sun protection and protection when they go out to avoid aggravating the disease or causing cross-infection.
V. Personal Insights
The parents blindly used medicine for a short period of time, but the wrong medicine may delay the treatment of the baby, but after targeted treatment, the baby’s symptoms are better relieved and the baby is back to health. However, the rash can be spread through contact with the respiratory secretions of the infected person, so parents are advised to take their babies outside and actively protect themselves from infection or the spread of the disease.