The Coxsackie virus, which our compatriots are bringing from Turkey this summer, caused panic among parents. "Letidor" publishes the post of pediatrician Sergei Butria for its readers. In it, the doctor explains how to recognize this disease and, most importantly, how to properly help the child.
The season of enterovirus exanthema has begun.
These diseases are recorded all year round, but from the onset of the summer heat to the first frost - such children visit the pediatrician especially often, from one a week to several a day.
Moreover, if in our latitudes it is just a widespread disease, then in southern latitudes it is extremely common; it can be safely considered the scourge of resort hotels; whole families fly in from vacation with such a rash.
Two words about them: enteroviral exanthems / enanthemas include mainly two main forms of the disease: hand-foot-mouth disease (aka enteroviral pemphigus, aka Turkish chickenpox), and herpangina (it is more correct to call Coxsackie-pharyngitis, since this disease has nothing to do with the herpes virus, but this name has historically "stuck").
With herpangina, a typical aphthous rash develops only on the palatine arches, less often in the oral cavity. With hand-foot-mouth disease, a rash occurs both on the palatine arches and on the tongue, the inner surface of the cheeks, around the mouth, on the palms and soles. The skin rash may resemble chickenpox (red spots / papules, and / or full watery blisters). A rash in the mouth may resemble herpetic stomatitis (it is important to distinguish them, because herpetic stomatitis is treated with acyclovir, but enterovirus is not).
What the rash looks like is clearly shown in the photographs, but it is not always so severe, more often - on each part of the body there are 2-5 elements of the rash.
The sick child is worried about sore throat and fever. Fever up to 39 lasts in the first 1-4 days, then it normalizes itself. Pain during swallowing lasts 1-6 days, sometimes so severe that the child does not even swallow saliva. The skin elements of the rash fester easily (especially those near the mouth) and turn into classic impetigo.
There is no specific treatment.
This is a spontaneous disease, so whatever you prescribe, it will pass within the usual terms for it: in 3-7 days.
Sometimes pediatricians foolishly prescribe antibiotics, antivirals, sorbents, antihistamines, etc. - but all this has no effect, except for the side effect, and is not recommended by modern clinical guidelines.
What should parents do?
Only 1) relieve the state of health, relieve pain 2) monitor dehydration, prevent it 3) monitor complications, consult a doctor in time.
1) Anesthetize. Nurofen (ibuprofen) or Efferalgan (paracetamol) in the first days of illness is best given in a course, every 6 hours, regardless of the height of the fever. This will relieve the malaise and dull the pain when swallowing. This will generally make the child feel better.
2) Water, water and water again. Dehydration in these diseases develops due to the fact that a) the child sweats a lot with fever, and b) the child drinks little because he is afraid to swallow because of a sore throat. Therefore, it is so important to anesthetize the child (see paragraph 1) and therefore you need to make sure that he drinks at least 1.5 liters of fluid per day.
It should be noted separately that children with enteroviral enanthems tolerate COLD DRINKS much easier.
That is, compote from the fridge, a milkshake from the fridge and melted ICE CREAM. Once again, at the risk of incurring thousands of grandmother's curses, I repeat: IT IS NECESSARY TO GIVE A SICK CHILD ICE CREAM with herpangin and "hand-foot-mouth". Firstly, because it is sweet, tasty, and a rare child will refuse such treatment (that is, he will receive at least some calories, after all, he does not eat at all for several days); and secondly, because the cold makes the mouth and throat go numb, and the pain dulls.
In all clinical guidelines, the recommendation Drink cold beverages is in the red line.
3) Watch out for complications. The most common complications of these diseases are dehydration and secondary bacterial infection.
a) Dehydration (crying without tears, extremely rare urination, excessive sleepiness, etc.) - is treated by setting a dropper for intravenous infusion of solutions. The clinic is unlikely to do this: for this you either have to be hospitalized in the infectious diseases department, or look for a private center where they are not afraid to administer intravenous drip infusions to children.
b) Secondary bacterial infection (pus appears at the site of the bubbles, oozing, redness, swelling, pain when touching, yellow crusts, etc.) - is treated with antibacterial ointments (Bactroban, Bonderm, Baneocin, Fuzidin, Levomekol, etc.) and / or antibiotics inside.
c) Serous meningitis is an extremely rare complication of enterovirus exanthema (I have never encountered it yet), but nevertheless regularly mentioned in the literature. It manifests itself as unbearable headaches, light and sound phobia, increased headache when trying to tilt the head forward, etc. If meningitis is suspected, you need IMMEDIATE hospitalization in the infectious diseases department.
If one child in the family falls ill, then all other family members are at risk, especially children under 10 years of age. The virus does not fly through the air, it is transmitted only by contact.
Therefore, a sick child should have their own toy spoons.
(mothers, do not finish eating cottage cheese and other food for a sick child, especially with a spoon!), and all family members are advised to often treat their hands with alcohol antiseptics (Sterillium, Dettol, etc.).
So, if you are faced with these sores - do not panic, give pain relief, give cool liquids to drink, consult a doctor in time if complications arise - and everything will be fine.