Exanthem subitum or Sixth disease, or Roseola Infantum as some parents call it, is generally the first fever experience for most babies. It is an elusive disease for moms and dads because the baby will have a fever before the rash grows. When a baby has a fever, mom and dad are usually confused, physical cooling can not reduce the fever, keep feeding Merlin or Tylenol, so carry the baby to the hospital, but the doctor is difficult to determine whether the fever is caused by the baby’s emergency rash. The mother and father were frightened for three or four days, and then found that the baby’s fever had suddenly gone down, and a lot of rashes had grown on his body, and only then did they realize that it was the toddler rash.
It is important to be calm in the face of toddler rash, although toddler rash is accompanied by high fever, but mom and dad should also be calm. It still has some telltale symptoms or clues that can be caught.
What is toddler rash? How does toddler rash happen?
It is a common febrile rash disease in infants and young children. It can occur all year round, with the majority of cases occurring in winter and spring, with no gender differences, and most cases occurring within 2 years of age, especially within 1 year of age. Human herpes virus types 6 and 7 are the causative agents of early childhood rash. Human herpes virus type 6 is the main causative agent of acute febrile illness in young children, and its importance lies in its ability to cause acute hyperthermia similar to very serious illness and to induce febrile convulsions.
The clinical characteristics of the acute rash in young children are a persistent high fever for 3 to 5 days, followed by a sudden reduction in fever and the appearance of a rash, i.e., “fever withdrawal from the rash” or “fever withdrawal from the rash” (which should be interpreted as “a red rash in the process of fever reduction, and the temperature slowly returns to normal after the rash is out). Some children do not have a normal temperature as soon as they get out of the rash).
The baby rash, often referred to as the “fever rash”, is transmitted through the respiratory tract and often spreads in childcare centers, where the child suddenly has a high fever and the temperature can rise to 39-41 degrees. Although the child has a high fever, he or she is in good spirits and some may have a mild cough, vomiting, diarrhea and other symptoms. The fever usually lasts for 3~5 days, then the body temperature suddenly drops, and a rash appears when the body temperature drops, i.e. the fever subsides and the rash comes out or the fever subsides.
The rash is characterized by small red spots scattered all over the body, more on the trunk, and rose-colored papules on the baby’s chest and head and neck, surrounded by a red halo, similar to rubella, measles or scarlet fever, and less on the face, below the elbows and knees. The rash appears in less than 24 hours and can disappear completely after 1 to 3 days. The rash does not leave a trace after it recedes. This is medically known as “rash out of fever”, and is a unique manifestation of early childhood emergency rash. The rash is accompanied by swollen lymph nodes in the neck, behind the ears, and behind the occiput, but there is no pressure pain, and it continues to subside for several weeks after the fever subsides.
The majority of babies develop E.R. between the ages of 6 months and 1.5 years after birth, most of them are 6 to 8 months old, and some are 4 to 5 months old. after 6 months, the baby’s immunity from the mother basically disappears, so this period is the most vulnerable to viral infections. If a healthy baby has a fever for the first time, after 6 months of age, and it suddenly reaches 38°C or higher and is difficult to reduce the fever, mom and dad should first consider whether the baby has the toddler rash. At this point, mom and dad should first calm down and not run to the hospital carrying the baby again and again to avoid cross-infection.
The rash is more difficult to diagnose before it appears and can easily be misdiagnosed as an upper respiratory tract infection and given anti-inflammatory, fever-reducing treatment. Parents do not need to worry, will not delay the child’s condition, because early childhood emergency rash generally rarely has complications, is an acute and good prognosis of rash infectious disease, the disease does not require special treatment, only symptomatic treatment. This is how modern medicine understands it.
In order to find out early if it is a toddler rash, you should first go to the hospital to get a clear diagnosis, improve blood tests and CRP tests to find out if it is a viral infection, and follow the doctor’s instructions to give your child medication on time, in case there is no major change in the condition, there is no need to run to the hospital every day because the fever does not go away. You should pay attention to give children more water, hot water, or hot rice soup, so that children sweat. Only when sweating, the body temperature can go down.
How should the blood routine and CRP initially determine whether it is a viral infection?
This is the most basic test. Generally, if a child has recurrent fever, the doctor will arrange it to facilitate early detection of serious diseases. The percentage of neutrophils is generally not more than 50% according to the age group in which early childhood rash is prevalent. This is a characteristic of pediatric blood picture, why would you say that, because many hospitals do not have reference values for the total number and percentage of blood cells for each age group. It is important for the doctor to judge the clinical situation and test results.
It is important to differentiate acute childhood rash from other febrile rash illnesses
It is not uncommon to see parents holding a child with a rash in their arms in the emergency department, and they ask, “Doctor, is my child having measles; is my child allergic to medication? Therefore, it is important to make it easy for parents and friends to understand.
It is not uncommon for fever and rash to coexist in pediatrics, so here are some of the common ones.
1, measles There is an overlap in the age of onset, it is characterized by a “hot rash”, that is, the rash and high fever at the same time, in contrast to the early childhood emergency, measles rash is high fever, typically high fever 3 days, rash 3 days, rash recede 3 days, before the rash there will be obvious runny, runny eyes, red eyes, the mouth will have white spots (referred to as The rash is preceded by marked runny eyes, red eyes, and white spots in the mouth (referred to as measles mucous membrane spots). The rash usually starts from the head and hairline and spreads throughout the body.
2. Rubella The rash is preceded by a fever of 6 to 24 hours, and the fever is accompanied by a rash, which is lighter. The rash is generally around 38°C, accompanied by a cough, a special rash as small as sand, a light red color, and enlarged lymph nodes behind the occiput and behind the ear. It is characterized by fever for one day, rash for one day, and rash for one day, referred to as “three-day rash”. The rash occurs mostly in young children, but can also be seen in school-age children. The main differentiation from this disease is the time of rash onset, rash shape and age. The rash is bright red and larger than rubella, and the rash comes out when the fever subsides.
3. Drug rash is caused by drug allergy, with a history of taking drugs, not necessarily fever, and no increase in blood lymphocytes.
Treatment of emergency rash in young children
(a) Modern medicine
1.If other symptoms are not obvious, physical cooling is sufficient.
2, symptomatic treatment: take antipyretic drugs (physical cooling: Merlin (ibuprofen suspension drops), Tylenol, Benadryl and other drugs to lower the temperature), reasonable identification of the use of proprietary Chinese medicine.
3, the temperature is too high hope that parents seek medical attention to deal with the prevention and control of high fever convulsions in babies. Convulsion medication is not suitable for home use, so not much is introduced. If convulsions occur, please promptly press the Renzhong and Hegu points, and pay attention to prevent tongue bite.
4. Special note: Do not use antibiotics for toddler rash, they are not effective. On the contrary, the use of antibiotics may cause other problems.
(B) How does Chinese medicine recognize this disease and is there any advantage?
The above describes the modern medical understanding of the disease, so next look at how Chinese medicine recognizes the disease.
As the rash of this disease resembles measles, it occurs in infants and young children, so Chinese medicine is called “milk hemp”, “false hemp”, and its cause is due to external wind-heat evil, depressed in the skin, and blood and qi wrestling knot. Early intervention of TCM can shorten the duration of fever in some children and facilitate the development of the rash.
The early stage of TCM treatment is to relieve the wind and relieve the symptoms, while the rash stage is to clear the heat and cool the blood to reduce the fever in time, and there is no other special treatment. According to Chinese medicine, the disease is mostly caused by external evil, depressed in the skin and the Qi and blood, and the outer surface of the muscle. Therefore, the method of clearing heat from the surface should be used. The application of this method can play a role in promoting the reduction of fever and preventing the retention of residual evil. The water decoction is divided into 3-5 times a day, and 30-50 ml is drunk each time.
It is worth mentioning the boiling of herbal medicine. This medicinal drug should be soaked in water for half an hour first, and then after boiling, it can be boiled for 15 minutes on a light fire, so that the medicinal properties can be preserved and the drug can be given full effect. In addition, Chinese medicine fumigation therapy is recommended to help reduce fever by using “the external treatment of Chinese medicine is the internal treatment”, which not only brings into play the curative effect of Chinese medicine, but also uses the effect of physical cooling, killing two birds with one stone. Therefore, it is recommended to intervene in Chinese medicine as soon as possible.
There’s no need to panic when it comes to emergency rash care
The rash is a benign rash, self-limiting disease (can be cured without treatment), there is no special antiviral drugs, so parents do not need to panic, usually do not need to use drugs to treat, just give physical cooling baby, while reducing outdoor activities, drink more water, more rest. The significance of proper care is greater than medication.
Specific care methods are as follows.
1, keep indoor air circulation, you can turn on the air conditioning, pay attention to the temperature and humidity, avoid too cold and too hot. Especially in the hot summer, normal people need to turn on the air conditioner to adjust the indoor temperature, and children with colds certainly need to adjust the indoor temperature. As long as the indoor temperature is adjusted properly, it can be adjusted between 27-28 degrees during the day and 28-30 degrees at night. As long as the cold wind does not blow directly on the child’s body, it is fine. Can be adjusted according to the air conditioning situation at home.
2, let the baby drink more plain water. If the baby does not drink, you can properly add some vegetable juice or fruit juice and other things that have a taste, note that it can not be cold. It is not recommended to give the baby to drink sugar water with high sugar content. The baby’s appetite is poor at this time, drinking it will affect the baby’s appetite.
3, eat easily digestible food. Already can eat solid food baby, at this time should eat a liquid or semi-liquid diet, pay attention to nutritious and balanced, appropriate to increase the food containing vitamin C and vitamin B.
4.Keep the environment quiet. When the fever baby needs more rest, the home should not be too noisy. Pay attention to regularly open the windows to keep the air flowing, and the covers should not be too thick when sleeping, which is not conducive to heat dissipation.
5, keep the skin clean and hygienic, advocate warm water bath or warm bath. Use a wet towel with warm water often, wring it slightly dry and wipe away the sweat stains on the baby’s body, focusing on the neck, arms, front chest, back, thighs and other parts of the body, located in the elbow, armpit, neck of the large blood vessels should be wiped more than a few times to prevent cold and prevent infection when the rash. Be careful not to use white wine or alcohol rubbing bath to prevent alcohol poisoning, this method has been eliminated.
6, to meet the baby’s psychological needs. When you have a fever, some babies may be very dependent on their mothers and want to stay in their arms. Please try to meet the baby’s psychological needs, which is conducive to recovery from the disease.
7, pay attention to observe the baby. If your baby’s temperature does not come down, or if the high temperature causes convulsions and so on, or if the fever is repeated for more than three days, whether or not it is a toddler rash, you should go to the hospital in time to prevent delayed treatment. I personally suggest that generally if there is a high fever, it is advisable to improve the blood routine, CRP test, screening, and then recheck if necessary
Prevention
In terms of prevention, parents should pay attention to the following points: children within the age of one year are not yet full of gas, not fully developed, and have poor resistance to disease, so do not take your child to the door or public places. Because there are many people in public places, the density of bacteria and viruses in the air is relatively high, so the possibility of children catching diseases will greatly increase; children within a week old must have a regular diet, after being able to add side dishes to pay attention to the intake of vegetables.
Chinese medicine believes that the spleen and stomach is the foundation of the human being, regular diet, rich, normal food to promote the development and growth of children. When the body is strong, the ability to resist disease will naturally increase; during the period of fever, the child should drink more water, warm water is better, do not drink glucose water. Because the appetite of children with fever is poor, glucose water will further affect the appetite of children, which is not conducive to the recovery of the disease.
In the diet is mainly light, fat, sweet and thick taste will make the qi stagnant, affecting the spleen and stomach transport, digestive function; during the illness of children’s body weak, should pay special attention to avoid wind and cold, careful not to sweat when the wind, that will attract new evil and cause repeated illness. When a child has a fever and sweats, a warm wet towel or a soft dry towel can be used to wipe the child, so that both heat dissipation and very comfortable.