Common illnesses in children

URI – Upper Respiratory Infection.

We see children and adolescents with viral upper respiratory infections: severe nasal congestion and secretions, sore throat, occasional vomiting and fever for 2-3 days. These symptoms are followed by a dry, persistent cough that may last for 7-14 days. Call us if the fever lasts greater than 3 days or if symptoms last longer than 10 days.

Cough

We see children and adolescents with cough, typically one of the most prominent and bothersome symptoms of viral respiratory infections at this time of year. Coughing is an important and beneficial reflex that our bodies need to clear secretions and to keep open our major airways during the course of a viral cold or upper respiratory infection. However, severe or persistent cough can be associated with asthma, pneumonia, sinus infections, and bronchiolitis, and should be evaluated by your health care provider.

Allergies

Seasonal allergies, or hay fever, are very common at this time of year. Typical symptoms include watery, itchy, red eyes; a clear runny nose; sneezing; and an itchy palate or throat. The most common triggers are trees in the spring, grasses in the summer, and weeds in the fall.

Effective non-sedating medications are now available for children over the age of 2 without a prescription for treatment of seasonal allergies. If you think your child has seasonal allergies and he or she is not responding to medication OR if you are not sure, please make an appointment in our office.

Many children do not require allergy testing if they respond to treatment with medication as needed.

Pink eye

We see children and adolescents with “pink eye.” Also known as conjunctivitis, this condition can be caused by either a viral or bacterial infection. Viral pink eye typically appears as red and watery eyes, and is accompanied by common viral cold or upper respiratory symptoms. This type of pink eye should resolve itself as the viral cold improves.

Bacterial pink eye usually appears as red eyes with yellow or green discharge. Upon awakening, the eyes often are matted shut with dried discharge. This type of pink eye also may be associated with a viral cold, but the bacterial eye infection itself requires antibiotic eye drops to cure. Good hand washing is very important because both viral and bacterial pink eye infections are very contagious.

Sore throat

We see quite a bit of strep throat. If your child has a fever, sore throat, headache, or stomachache without any other viral symptoms like congestion or cough, it may be strep throat. Bacteria, called Group A strep, cause this type of sore throat. To diagnose strep throat, your physician will require a swab of your child’s throat, and antibiotics will be needed if the strep test is positive.

Vomiting and diarrhea

We see viral illnesses that cause vomiting and diarrhea. Usually called viral gastroenteritis, the virus causes inflammation and irritation of the stomach and the intestines, leading to vomiting and diarrhea. This illness, often called the “stomach flu” typically lasts 1-2 days, with diarrhea lasting a few days longer.

It is important to make sure that your child does not get dehydrated with this condition. Offer Gatorade 2 or Pedialyte in small amounts every 10-20 minutes until your child can keep liquids down. If they are unable to keep liquids down, back off for 2 hours, then try the small amounts again. If your child has very few wet diapers and does not make tears, or appears limp or lethargic, they may be dehydrated and we will need to see them in our office.

Enteroviruses

We see children and adolescents with infections caused by the enteroviruses, a group of viruses that often cause illness during the summer and the early fall months. The commonly used term “enterovirus” includes the coxsackie viruses, the echoviruses, and the enteroviruses. These viruses often cause a fever, and also may cause a rash, respiratory or cold symptoms, and vomiting with diarrhea. Hand-foot-mouth disease, a rash that involves those areas of the body, is a common enteroviral infection that occurs in children. More serious illnesses that are caused by these viruses include meningitis, heart infections, and eye infections. For mild illnesses caused by the enteroviruses, the best treatment is adequate rest, plenty of fluids, and fever control.

Hand foot mouth disease

Hand-foot-mouth disease is a common viral illness caused by the Coxsackie A-16 virus (a member of the enterovirus family). Its name describes the location of the rash during the illness.

Typically children experience fever and small blisters in the mouth in the first few days followed by small blisters on the hands and then feet. Sometimes the rash is seen in the diaper area as well. The mouth blisters can be painful. Ibuprofen or acetaminophen can be given as needed for pain relief. It is important to make sure your child receives plenty of fluids. Cold liquids and popsicles may provide pain relief as well.

Call our office for an appointment if you think your child may be showing symptoms of dehydration during this illness (urinating less than every 8 hours, dry mouth, or lethargy); if the fever persists after the first 3-4 days; or if you cannot keep the pain under control.

Dehydration

The main risk of not drinking enough fluids is dehydration. This means the body has lost too much water. It is a reason to see your doctor right away. Your child may have dehydration if not drinking much fluid and:

• The urine is dark yellow and has not passed any in more than 8 hours.
• Inside of the mouth and tongue are dry.
• There are no tears if your child cries.
• Slow blood refill test: longer than 2 seconds. First, press on the thumbnail and make it pale. Then let go. Count the seconds it takes for the nail to turn pink again. Ask your doctor to teach you how to do this test.

A child with severe dehydration becomes too weak to stand. They can also be very dizzy when trying to stand.