American Medical Association Family Medical Guide - American Medical Association [214]
A diagnosis of roseola infantum is based on the child’s symptoms and a physical examination. In some cases, a doctor may order tests to rule out other possible causes of the symptoms.
Treatment for roseola focuses on reducing the fever. Give your child a sponge bath with lukewarm water and dress him or her in lightweight clothing. Do not use ice, cold water, rubbing alcohol, or a fan to lower your child’s temperature; they can cause shivering, which can raise the temperature even more. The doctor will recommend that your child rest and drink plenty of fluids, including water, over-the-counter electrolyte solutions, sports drinks, or clear broth. The doctor also will recommend giving your child a nonprescription fever-reducing medication such as acetaminophen or ibuprofen. (Do not give aspirin to a child or adolescent who has a fever because aspirin has been linked to a potentially fatal disorder called Reye’s syndrome; see page 411.)
Most children recover from roseola infantum in about a week. There is no vaccine available to prevent roseola, but having the disease usually provides lifelong immunity.
Fifth Disease
Fifth disease (also called erythema infectiosum or “slapped cheek” disease) is a highly contagious infection caused by a type of virus called a parvovirus. The infection spreads easily among children through direct contact. Outbreaks of fifth disease occur most often in the spring and early summer, affecting mostly children between ages 5 and 15. A possible complication of fifth disease is acute bone marrow failure, a life-threatening condition in which the bone marrow stops producing red blood cells (which deliver oxygen to tissues), white blood cells (which fight infection), and platelets (which enable blood to clot).
Symptoms
The main symptom of fifth disease is a rash of flat red spots, rings, or patches that make the face look like it’s been slapped (because the sides of the face are bright red). However, the rash also may appear on the trunk, arms, legs, and buttocks and sometimes is accompanied by joint pain. Exercise or bathing can make the rash worse. Once the rash appears, the infection is no longer contagious. Other symptoms include a slight fever, a sore throat, swollen lymph glands in the neck, a headache, red eyes, a stuffy or runny nose, and diarrhea.
Diagnosis and Treatment
A diagnosis of fifth disease is based on a child’s symptoms and a physical examination. In some cases, the doctor may order a blood test to detect the parvovirus. To treat fifth disease, doctors recommend rest, plenty of fluids, and acetaminophen or ibuprofen to reduce fever and relieve pain. (Do not give aspirin to a child or adolescent who has a fever because aspirin has been linked to a potentially fatal disorder called Reye’s syndrome; see page 411.) Apply a soothing cream or lotion to the rash if it itches. Recovery usually takes about 10 days, although the rash can last for up to 3 weeks. If joint swelling occurs, it can last for months or even years.
Prevention
There is no vaccine available to prevent fifth disease, but having the disease usually provides lifelong immunity. Good hygiene, especially frequent handwashing, can help prevent the infection. Pregnant women who have been exposed to fifth disease should contact their doctor right away; an infection in the fetus can block fetal red blood cell production, which can lead to anemia or heart failure in the fetus, or can be fatal to the fetus.
Chickenpox
Chickenpox (also called varicella) is a very contagious viral infection caused by a type of herpesvirus called the varicella zoster virus, the same virus that, after years of dormancy, can cause shingles (see page 936) in adults. The infection usually occurs in late winter or early spring and primarily affects the skin and the membrane lining of the mouth and throat. A chickenpox vaccination is required for all children between 12 months and 23 months of age.
Symptoms
The main symptom of chickenpox is a rash of small, red, fluid-filled blisters that appears initially on the trunk and then spread