Peds Skin/Infectious Disease

Varicella

-Pruritic, blister-like rash over whole body with associated fever, fatigue, loss of appetite & HA. -Airborne & Contact Precautions
-Contagious until all blisters have crusted

Erythema Infectiosum

Fifth Disease"
-Starts as mild illness, then
fiery-red rash on cheeks
(slapped face appearance),
lace-like red blotches
to trunk, arms and legs.
-Rashes fade over 1-3 weeks, may reappear after sun exposure
-Standard and droplet precautions
May return to

Rubeola

Measles
Stage 1:
Fever (Tmax104F), Conjunctivitis, KOPLIK SPOTS
, Cough/Runny nose
Stage 2: Rash begins on head then spreads down.
-Most contagious: 4 days before and 4 days after rash appears.
-Airborne Precautions

Mononucleosis

S&S:
Sore throat, swollen cervical lymph nodes, swollen spleen/liver
, fever, fatigue, HA.
-Standard Precautions
Do not share food/drink, no more kissing plz
No contact sports
Return to school once fever free

Hand, Foot, Mouth Disease

S&S:
Painful mouth sores, rash to palms & soles
, fever, fatigue, HA, sore throat. (Sometimes asymptomatic)
-Standard Precautions
Analgesics for mouth sores, encourage fluids
Parents should disinfect frequently
Return to school once fever free & feels bet

Mumps

Parotitis
S&S:
Swollen salivary glands
, fever, myalgias. (Sometimes asymptomatic)
-Standard & Droplet Precautions
Most contagious 5 days before and after parotid swelling
Return to school 5 days after swelling onset
-Isolate from children not immune to v

Pertussis

Whooping Cough
Catarrhal Stage
: Cold-like symptoms w/ cough lasting 1-2 weeks
Paroxysmal Stage
: Coughing spells, narrow glottis causes inspiratory stridor = whoop sound
Convalescent Stage
: Coughing spells gradually decrease over 6-10 weeks
DROPLET prec

Poliomyelitis

S&S:
Paresthesias, Meningitis, Asymmetric Paralysis/Weakness in arms/legs
, Fever, Fatigue, Nausea, Abd Pain.
-Standard and Droplet Precautions
Monitor for respiratory paralysis
ROM exercises to prevent contractures

Roseola

Sixth Disease
Prodromal Stage
: Sudden high fever (Tmax >103F) for approx 1 week, no rash.
Rash Stage
: Pinkish-red flat or raised maculopapular rash with "halo" around spots. Starts on trunk then extremities.
-Standard Precautions
Ibuprofen/Tylenol for f

Rubella

German Measles
S&S:
Low grade fever, maculopapular rash to face & neck then trunk & extremities
, fatigue, mild pink eye
-Standard and Droplet Precautions
Most contagios 7 days before and after rash appears

Congenital Rubella

Infants born to mother exposed to rubella while pregnant.
-If exposed 1st trimester, risk for defects
Contact precautions for 1 year

Scarlet Fever (Group A Strep)

S&S: Red sore throat, fever, thrush, strawberry togue,
Rash to neck, underarms, groin that feels like sandpaper, body creases bright red
.
-Droplet and Contact Precautions
-When rash fades, may peel around finger tips, toes, and groin
Rest, increase fluid

Tetanus

Lockjaw"
S&S:
Spasm/Stiffness of jaw, Neck Stiffness, Opisthotonos
, fever, increase HR/BP, diaphoresis
-Standard Precautions
-Occurs after exposure to contaminated object
Wound care
Reduce stimuli
Monitor respiratory status, feed via tube or TPN, hydrat

Lyme Disease

S&S:
Erythema migrans rash (BULLSEYE)
, Fatigue, Fever/Chills, Joint Pain, Swollen Lymph nodes.
-Occurs 1-32 days after tick bite
Treated with Amoxicillin
Educate on safe tick removal

Rocky Mountain Spotted Fever

S&S:
Fever, Red Splotches/Pinpoint Dots Rash onset 1-5 days after fever
, N/V, myalgias.
-Occurs after tick bite
Treated with doxycycline
Observe for signs of bleeding

Severe Combined Immunodeficiency (SCID)

Genetic disorder causing infant to be immunocompromised.
S&S: FTT, Diarrhea, Frequent Respiratory Illness, Recurrent Infections
Treatment = Stem Cell Transplant
-Isolation Precautions
-No live vaccines
-Limit exposure to people

Contact Dermatitis

Inflammation of skin in response to direct contact with allergen or irritant
Treatment
: Medium potency topical corticosteroid, BID 2-3 weeks to avoid rebound

Phytophotodermatitis

Contact with citrus fruits, celery, parsley, fennel, fig leaves, or rag weed.
Due to furocoumarin
Erythema & blisters then hyper pigmentation 1-3 weeks

Allergic Contact Dermatitis

Delayed T-cell mediated hypersensitivity reaction
S&S:
Erythema, edema, pruritus, vesicles/bullae that rupture, ooze, and crust.

Diaper Dermatitis

Raw, moist, weeping macules and papillose of skin in contact with diaper. Skin folds spared.
Caused by
C. albicans: bright red, beefy plaques with sharp margins that rupture and cause scales. Skin folds may be affected.
Treat with topical corticosteroids,

Atopic Dermatitis

Eczema
-Chronic, relapsing, superficial, inflammatory skin condition
-Associated with asthma or food allergies
Appearance: Patches with papules, vesicles, exudate, crusting, and excoriation. Darkened, thickened, skin.
Manage with topical corticosteroids,

Acne

Inflammation of pilosebaceous hair follicles.
-Obstructed commandoes cause inflammatory response
Whiteheads
= Closed Comedones
Blackheads
= Open Comedones
-Nodules
-Cysts
Do not pick/squeeze, good hand hygeine

Cellulitis

Bacterial infection causing acute inflammation of deep layer of skin.
Caused by
Streptococcus pyogenes or S. aureus bacteria
Appearance:
Red or lilac, tender, warm, edematous skin around site of infection
Treatment: PO antibiotics for 10 days, warm compre

Impetigo

Bacterial & VERY contagious
Minor skin injuries provide portal for bacteria
Caused by
group A beta-hemolytic strep or S. Aureus bacteria
Sites: face, mouth, hands, neck, extremities
Non-bullous Appearance: Begins as papule, vesicle ruptures with serous fl

Oral Candidiasis

Thrush
Fungal infection caused by C. albicans
Appearance: White patches on tongue, may bleed if removed.
Treatment:
PO Nystatin Suspension or Clotrimazole
, Fluconazole/Itraconazole if immunocompromised, IV Amphotericin B if systemic.
-Infants might not n

Tinea Capitis

Fungal infection of scalp
Appearance:
Scaly, pustular patches. May appear as yellow, greasy scales
, Pruritic, Breaks Hair
Kerion
: secondary infection
Treatment: Griseolfulvin PO 8-12 weeks, Terbinafine PO 6 weeks, Selenium sulfide/Ketoconazole shampoo 2

Tinea Coporis

Fungal Infection of skin of trunk
Appearance:
Pink, scaly, circular patches with raised borders with clear center
Treatment: Topical antifungal creams BID 4-6 weeks

Tinea Cruris

Jock Itch
Fungal Infection in groin area
Appearance:
Scaly, annular lesions on groin and upper thighs
Treatment: Topical antifungal creams BID 4-6 weeks, Selenium sulfide shampoo
Wear loose clothing

Tinea Pedis

Athlete's Foot
Fungal infection of feet
Appearance:
Vesicles or erosions on instep or between toes. Red, scaly fissures. Pruritic.
Treatment: Broad spectrum antifungal, air dry feet, 100% cotton socks changes BID.
-Peeling, maceration & fissures in web sp

Pediculosis Capitus

Lice infestation of hair and scalp.
Transmitted by either direct or indirect contact.
Appearance:
Nits are silvery-white, yellow, or darker teardrops. Pruritic.
Looks like dandruff.
Treatment: Pediculicide shampoo, removal with fine toothed comb, 2nd trea

Scabies

Caused by
Sarcoptes scabiei mite
HIGHLY contagious, skin to skin contact/sexual contact
Appearance:
Rash with papules and pustules, lesions that are thread-like grayish burrows. Severe pruritus, worse at night
-Microscopic exam to confirm diagnosis
Treatm

Hemangioma

Vascular tumors
Appearance:
Begin as faint telangiectasis (red macules) the grow rapidly to bright red compressible macules
Diagnosed by PEx and monitor growth
Treatment: Usually none.
Assess distribution, support family

Animal Bites

Assess: Location & number of puncture wounds, abrasions, lacerations, possible crush injury
Treat: Irrigate, remove devitalized tissue, apply clean dressing
Teach risk for infection and proper wound care

Human Bites

Assess: Break in skin, redness, bruising, abrasions, or lacerations.
Treat: Irrigate with sterile saline, remove revitalized tissue, apply clean dressing
Mouth harbors natural bacteria so high risk for infection, teach proper wound care
Assess for Hep B o

Insect Bites

Low concern.
Prevention is key