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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Thursday, February 9, 2012
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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Thursday, February 9, 2012
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Children's Health |
15 mon with rash on body, blisters on feet09/27/2006 |
my daughter came down with a rash on her entire body, took her to the doctor and he said it was viral infection, a day later she started having blisters on her feet and a few in the mouth. I just really don`t feel comfortable with the doctor and am searching for myself. Any thing you can tell me would really help...
Skin rashes are a real challenge in pediatrics. They account for 20% or more of pediatric doctor visits while they form only 1-2% of outpatient visits for adults. Children's skin is far more vulnerable to various infections and reactive to stimulation of the immune system by foods, medications, environmental toxins, and infections in the body than is the skin of adults.
There are many possible diagnoses for your toddler depending on whether you child has had all of her immunizations, allergies that run in your family, exposures to allergens to which she is sensitive, exposures to ill children, medication reactions, and all of the other symptoms that have preceded or accompanied the appearance of the rash. Without seeing your child and doing a thorough history and physical, it's impossible to say what the true diagnosis is for your child.
Your child's doctor is very likely correct that she had a viral illness. Several possible infections viral infections in her age group include include roseola, measles, rubella, varicella or chicken pox, hand-foot-and-mouth disease caused by the Coxsackie virus, and herpes virus to name just a few. None of these viral infections have a cure. There are anti-virals that can lessen the length and severity of some infections if they are caught very early, but for the most part, treatment is symptomatic to relieve fever, itch, sore mouth pain, etc.
The unfortunate truth is that the same viral illness can present in a variety of ways in different children and that there is no cure for viral illnesses at this point in time. Another unfortunate truth is that viral illnesses have different presentations at different points in time. Seeing the sores in your daughter's mouth and on her hands the next day may have helped the doctor make a specific viral diagnosis, but it is unlikely that treatment would have changed. The most important things that doctors and nurse practitioners establish when they see a child with a rash is whether or not there is a treatable bacterial infection or is the rash due to an allergic response to a medication or other allergen that can be eliminated for the child, allowing the rash to resolve. Sometimes, we just don't know exactly what the problem is, only that it does not appear to be bacterial or allergic in nature.
Going back and forth to the doctor's office is no fun. It takes time and costs money. But if you find yourself again in the position of being dissatisfied with your child's care, it is a good idea to take your child back and ask for a re-evaluation, especially if new symptoms have occurred. Ask for better explanations of your child's problem and its treatment if you feel uncertain. Good doctors and nurse practitioners appreciate parents who ask questions and remind us that parents need to understand their child's health problems and their treatment, even when they are not serious threats to the child's health and well being.
If you remain interested in finding a new doctor for your child, there is a good guide entitled, Finding a Pediatrician, developed by the American Academy of PEdiatrics and posted on www.medem.com to use in screening potential professionals. An essential criterion I value is that the doctor or nurse practitioner is board certified in pediatrics.
I hope this information is helpful.
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Mary M Gottesman, PhD, RN, CPNP, FAAN Associate Professor, Specialty Program Director Pediatric Nurse Practitioner Program College of Nursing The Ohio State University |
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