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Common Childhood Infections

Bronchiolitis:

Bronchiolitis is a common disease of the lower respiratory tract (the bronchioles). It occurs most often in the winter. Bronchiolitis causes coughing, wheezing, and breathing trouble. It is most commonly found in children under 2 years of age. It often develops in infants and toddlers after they come into contact with someone who has an upper respiratory tract illness. Bronchiolitis starts like a normal cold, with a runny nose and sneezing. After a few days, a child with bronchiolitis will develop a wheezy cough and trouble breathing. She may be cranky too. The cough and breathing problems may make it hard for her to eat. In some infants with severe bronchiolitis, symptoms appear much more quickly. Bronchiolitis is usually caused by a virus that leads to swelling of the small bronchial tubes. This traps air and mucus in the lungs. Children with mild cases, especially those with a thick nasal mucus, may get some relief with a cool-mist vaporizer. A child who has a lot of trouble breathing may need to go to the hospital for oxygen and fluids. Sometimes medication may be used to help open the bronchial tubes and improve breathing. A specific virus called respiratory syncytial virus (RSV) can cause bronchiolitis. If infection with RSV is severe or occurs in infants who also have a chronic illness (especially heart disease or lung disease), an antiviral agent called ribavirin (Virazole) can be used in the treatment.

Pneumonia:
Pneumonia is an inflammation of the lungs. The symptoms vary based on the cause and severity of the illness. Viruses cause most pneumonias in children. Luckily these illnesses are mild. A child may have a cough, mild fever, and decreased appetite and energy. Viral pneumonias are often treated with acetaminophen for fever and are sometimes treated with bronchodilators (if there is wheezing). Bacterial pneumonias tend to have more severe symptoms, and they respond best to therapy with antibiotics, fluids, and humid air. Pneumonia often occurs a few days after the start of an upper respiratory tract infection. If one of the more severe types of pneumonia develops, your child may suddenly have shaking chills; a high fever; difficult, rapid breathing; and other breathing problems. A cough may not develop until later. In many cases your pediatrician may need an x-ray to make sure that pneumonia is the cause of the symptoms. Most cases of pneumonia can be safely treated at home. If the symptoms are severe or your child is under 6 months of age, however, he may need to go to the hospital for treatment.

Conjunctivitis (pinkeye):
Pinkeye is an infection that causes painful or itchy, red eyes. The undersides of your child’s eyelids may also be irritated. To treat pinkeye, your pediatrician may prescribe warm compresses and antibiotic drops or ointment. If the redness and swelling remain after a few days of treatment, it may mean a virus or allergy is causing the pinkeye. Let your pediatrician know if your child has eye irritation with a high fever, sluggishness, or more severe swelling and redness around the eye. These could be signs of a more serious infection. Not all pinkeye infections are contagious. Your pediatrician can let you know whether your child should stay out of school or the child care center until the infection clears.

Sty:
A tender, local swelling and redness on your child’s eyelid are usually signs of a sty. This is an infection in a gland of the eyelid. To treat a sty, apply warm compresses often. Let your pediatrician know if this does not work. He or she may then prescribe an antibiotic ointment or refer your child to an eye doctor who can drain the sty surgically. Sties are not very contagious.

Vomiting and diarrhea:
Vomiting and diarrhea are the reasons many parents call the pediatrician. These illnesses are usually caused by viruses that infect the intestine. They usually last only about a day or two, but in some cases they can last up to a week. If your child is throwing up, your pediatrician may tell you to not give food and fluid for a few hours. You can then give your child small sips of clear fluids, later followed by easy-to-digest foods. This will help pre-vent more vomiting, which can lead to dehydration. Diarrhea is frequent, loose, watery stools. You may need to stop feeding your child solid foods and milk for 12 to 24 hours and instead give an oral electrolyte solution to prevent dehydration. You can buy this at your local drugstore. Giardia is a parasite that infects the bowel and often causes prolonged diarrhea. It can be a problem, especially for those in child care centers and rural areas. If your child’s diarrhea does not clear up, your pediatrician may test for Giardia. Disease caused by Giardia is treated with medication. Mild vomiting and diarrhea rarely cause dehydration. However, if your child is dehydrated, she may:
        • seem tired or have less energy
        • produce less urine or tears
        • have a dry mouth
        • have sunken eyes Some children may throw up many times over several days.

If this occurs, and you notice any of the other symptoms listed previously, your pediatrician will want to examine your child. These symptoms may indicate dehydration or, less often, the first signs of a rare condition known as Reye syndrome. As Reye syndrome has been linked with taking aspirin during certain viral illnesses, you should never give aspirin to an infant or child. If dehydration occurs, your child may need to have an intravenous (IV) tube inserted to receive fluids through her veins. To reduce the chance of dehydration, call your pediatrician early if your child has vomiting or diarrhea that will not go away.

Urinary tract infection (UTI):
Urinary tract infections (UTIs) are found in children from infancy through adolescence. A UTI occurs in the kidney or bladder and can cause the following symptoms: • fever • painful and frequent urination • vomiting • abdominal pain Treatment of UTIs consists of taking an antibiotic for about 10 days. Even though your child shows signs of improvement within 1 to 2 days of starting to take an antibiotic, he must still finish the entire prescription. X-rays and other tests are often needed to help determine the causes of the UTI.


Impetigo (skin infection):
Your child may have a skin infection called impetigo if a scratch turns into a yellow, oozing, crusty sore surrounded by redness. Impetigo can spread on the skin quickly. It can also spread to other people if they touch the infected skin lesions, by fingers, or from soiled clothing. This infection is most common in warm weather. An antibiotic, taken by mouth or in ointment form, is used to treat impetigo. If any of these illnesses or infections develop, remember that your pediatrician is your best source of help. Most important, if the illness or infection does not seem to go away, or appears to get worse, your pediatrician needs to know. Always call when you are concerned.


Signs of infection in an infant:
These are the signs of infection in an infant under 2 months of age. Since infections can be especially dangerous in a child this young, call your pediatrician right away if your child develops any of these symptoms: • poor feeding • poor color • listlessness • weak cry • rectal temperature of at least 100.4°F • breathing problems • unusual fussiness • sleeping more than usual • vomiting or diarrhea
 
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