American Medical Association Family Medical Guide - American Medical Association [219]
Diagnosis and Treatment
A diagnosis of scarlet fever is based on a child’s symptoms and the results of a physical examination. The doctor may also order a laboratory analysis of samples of secretions from the child’s throat to check for group A streptococcal bacteria.
To treat scarlet fever, doctors prescribe either oral or intravenous antibiotics. It is very important for your child to take the entire prescription as instructed. The child may need to be isolated from other family members for the first 48 hours, when the infection is contagious. The doctor will recommend giving your child plenty of fluids, such as water, fruit juice, and clear broth. He or she also may recommend providing soft, bland foods or a liquid diet. Try using a cool-mist humidifier at night in the child’s bedroom to help make breathing easier. A warm, moist towel applied to the child’s neck can help soothe swollen glands.
There is no vaccine to prevent scarlet fever, and having the disease does not provide immunity. Most children with scarlet fever recover completely with no lasting effects.
Diphtheria
Diphtheria is a highly contagious, life-threatening bacterial infection that affects the nose and throat and usually occurs in children younger than 5. The bacteria that cause diphtheria can be spread by sneezing, coughing, or laughing. If not treated promptly, the infection can damage the heart, kidneys, and nervous system and can cause permanent disability or death. Diphtheria rarely occurs in the United States because of widespread childhood immunization against the disease. The vaccination is given in a combined vaccine with tetanus and whooping cough (DTaP; see page 376), beginning at 2 months of age and four more times up to age 6 years. Having diphtheria does not provide immunity.
Symptoms
The symptoms of diphtheria include sore throat, a slight fever, rapid heartbeat, swollen lymph glands in the neck, difficulty swallowing, difficulty breathing, and, occasionally, a thick, yellow discharge from the nose. In the advanced stages, symptoms can include double vision, slurred speech, paralysis, or shock (see page 579). The most dangerous symptom of diphtheria is a grayish membrane that forms on the throat and tonsils. The membrane may become large enough to cause croup (see page 420) or obstruct breathing. Contact your doctor immediately if your child has symptoms of diphtheria.
Diagnosis and Treatment
A diagnosis of diphtheria is based on a child’s symptoms and the results of a physical examination. The doctor may order a blood test or a microscopic examination of secretions from the nose and throat to detect the diphtheria bacteria.
To treat diphtheria, a child is hospitalized and isolated from other patients to prevent the infection from spreading. He or she is given injections of antibiotics to kill the bacteria, and antitoxins to neutralize the toxins the bacteria produce. In some cases, these medications may be given intravenously (through a vein). If a child’s breathing is blocked, a temporary tracheotomy (an airway opening cut into the windpipe) may be necessary to restore breathing, or a child may be put on a ventilator to assist breathing. Supplemental oxygen may also be necessary. If the bacterial toxin spreads to the kidneys, heart, or nervous system, the doctor may prescribe intravenous fluids or nonsteroidal anti-inflammatory drugs to reduce inflammation and assist breathing. The child will need to rest in bed for about 4 to 6 weeks or until he or she has recovered fully.
Pinworms
Pinworms are tiny white worms that frequently infest the intestines of young children. The eggs of pinworms can easily enter a child’s body when he or she touches contaminated food or contaminated clothing, toys, or a sandbox. The eggs hatch in the intestines, and young worms quickly begin to grow