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67 Cards in this Set
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Chickenpox (Varicella)
Cell-Free Live Attentuated (Varivax) First Dose: 12-15 months Second Dose: 4-6 years 0.5ml Sub Q 13 and over: 2 doses 4 weeks apart KEEP FROZEN AND USE WITHIN 30 MINUTES CAN GIVE SIMULTANEOUSLY WITH MMR - SEPARATE SITES IF NOT GIVEN SIMULATENOUSLY - 1 MONTH APART BETWEEN VARICELLA AND MMR MAY GIVE SIMULATANEOUSLY WITH DTaP, IPV, HepB or Hib PREVENTS VARICELLA FOR ELEVEN YEARS |
Agent: Varicella-zoster virus
Source: Secretions of respiratory tract of infected persons or skin lesions (SCABS NOT INFECTIOUS) Transmission: DIRECT DROPLET (AIRBORNE) CONTAMINATED OBJECTS |
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Chickenpox (Incubation Period):
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2-3 weeks; usually 14-16 days
Period of communicability: Probably 1 day before lesions erupt (PRODROMAL PERIOD) to 6 days after first crop of vesicles when crusts have formed |
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Prodromal Stage:
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Slight fever, malaise, anorexia for first 24 hours
Rash highly PRURITIC: Begins as MACULE Progresses to PAPULE then VESICLE surrounded by ERYTHEMATOUS BASE becomes CLOUDY AND UMBILICATED breaks easily; forms CRUSTS All THREE STAGES (papule, vesicle, crust) PRESENT in varying stages at one time |
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Chickenpox (Distribution)
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Centripetal
Spreads to FACE AND PROXIMAL EXTREMITIES SPARSE on distal limbs LESS on areas not exposed to heat (from clothing or sun) |
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Constitutional S/S (Chickenpox):
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Elevated temperature from lymphadenopathy
Irritability from pruritis |
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Management/Complications (CHICKENPOX)
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1) Antiviral agent ACYCLOVIR (ZOVIRAX)
2) Varicella-zoster immune GLOBULIN (VariZIG) or 3) IVIG (after exposure in HIGH-RISK children |
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Supportive (Chickenpox)
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Relieves Itching:
1) Diphenhydramine hydrochloride 2) Antihistamine Skin care: Prevent secondary bacterial infection (give bath, change clothes and linens daily) SECONDARY BACTERIAL COMPLICATIONS: 1) Abscesses 2) Cellulitis 3) Necrotizing fascitis 4) Pneumonia 5) Sepsis 6) ENCEPHALITIS 7) Varicella pneumonia (rare if child healthy) 8) HEMORRHAGIC varicella (tiny hemorrhages in vesicles and numerous PETECHIAE in skin 9) Chronic/transient THROMBOCYTOPENIA |
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Preventive (Chickenpox)
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Childhood immunization
DISEASE DOES NOT CONFER IMMUNITY |
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PRECAUTIONS (CHICKENPOX)
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Maintain (if hospitalized - UNTIL ALL LESIONS ARE CRUSTED)
1) STANDARD 2) AIRBORNE 3) CONTACT IMMUNIZED CHILD WITH MILD BREAKTHROUGH VARICELLA: Isolate until no new lesions are seen KEEP CHILD IN HOME away from susceptible individuals until vesicles have DRIED (USUALLY 1 WEEK after onset of disease) ISOLATE HIGH RISK CHILDREN FROM INFECTED CHILDREN |
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Skin care (Chickenpox)
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1) Give bath, change clothes/linens daily
2) Administer TOPICAL CALAMINE lotion 3) Fingernails short (apply mittens) 4) Keep child COOL (may decrease number of lesions 5) To lessen pruritis - KEEP CHILD OCCUPIED REMOVE LOOSE CRUSTS THAT RUB AND IRRITATE SKIN TEACH CHILD TO APPLY PRESSURE RATHER THAN SCRATCHING NO ASPIRIN!!!! REYE'S SYNDROME!!!! |
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DIPTHERIA
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Agent: Corynebacterium diphtheriae
Source: 1) Discharges from MUCOUS MEMBRANES of NOSE and NARSOPHARYNX and SKIN 2) LESIONS OF INFECTED PERSON |
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DIPTHERIA - INCUBATION PERIOD
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Usually 2-5 days, possibly longer
PERIOD OF COMMUNICABILITY: Variable, until virulent bacilli are no longer present (IDENTIFIED BY THREE NEGATIVE CULTURES) Usually TWO WEEKS but as long as FOUR WEEKS |
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CLINICAL MANIFESTATIONS: DIPTHERIA!!!!!
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NASAL:
1) Mimics COMMON COLD (serosanguineous mucopurulent NASAL dischrge 2) POSSIBLE FRANK EPISTAXIS TONSILLAR-PHARYNGEAL 1) Malaise 2) Anorexia 3) Sore throat 4) Low-grade fever 5) Pulse INCREASED!!! 6) Smooth adherent WHITE/GRAY MEMBRANE 7) Possible lymphadenitis |
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CLINICAL MANIFESTATIONS (CONTINUED - DIPTHERIA
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LARYNGEAL
1) Fever 2) Hoarseness 3) Cough 4) Potential AIRWAY OBSTRUCTION 5) APPREHENSIVE 6) Dyspenic RETRACTIONS 7) CYANOSIS |
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Therapeutic Management (Diptheria)
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1) Equine antitoxin (usually IV)
(preceded by skin or conjunctival test to r/o sensitivity to horse serum 2) Antibiotics (PENICILLIN) -Penicillin G procaine or -Erythromycin PLUS EQUINE ANTITOXIN COMPLETE BED REST!!!!! PREVENT MYOCARDITIS!!! TRACHEOSTOMY FOR AIRWAY OBSTRUCTION TREAT INFECTED CONTACTS/CARRIERS |
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Diptheria (COMPLICATION!!!)
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TOXIC CARDIOMYOPATHY!!!!!!!!
SECOND TO THIRD WEEK TOXIC NEUROPATHY!!!!!!!!!!! |
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Diptheria (Prevention)
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Childhood Immunization
DISEASE DOES NOT CONFER IMMUNITY |
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PRECAUTIONS (DIPTHERIA)
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Follow:
1) Standard 2) Droplet 3) Contact (with cutaneous manifestations!!!) UNTIL TWO CULTURES ARE NEGATIVE FOR C. DIPHTHERIAE!!! Administer antibiotics timely Participate in sensitivity testing: having EPINEPHRINE available!!! BED REST SUCTIONING OBSERVE RESPIRATION FOR SIGNS OF OBSTRUCTION ADMINISTER OXYGEN AS PRESCRIBED UNTIL TWO CULTURES ARE NEGATIVE FOR C. DIPHTHERIAE |
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ERYTHEMA INFECTIOSUM (FIFTH DISEASE)
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Agent: Human parvovirus (HPV) B19
Source: Infected persons; mainly school-age children Transmission: Respiratory secretions and BLOOD, BLOOD PRODUCTS) Incubation Period: 4-14 days, may be as long as 21 days PERIOD OF COMMUNICABILITY: Uncertain but before onset of symptoms in children with APLASTIC CRISIS |
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ERYTHEMA INFECTIOSUM (FIFTH DISEASE)
CLINICAL MANIFESTIONS!!! |
Rash appears in THREE STAGES:
1) Erythema on face, mainly cheeks ("SLAPPED FACE") disappears 1-4 days 2) Approximately 1 day after rash appears on face, maculopapular RED SPOTS appear: symetrically distributed on UPPER AND LOWER EXTREMITIES - Rash progresses from PROXIMAL to DISTAL and may last a week or more 3) Rash subsides but REAPPEARS if skin is irritated or traumatized (SUN, HEAT, COLD, FRICTION |
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ERYTHEMA INFECTIOSUM (FIFTH DISEASE)
CHILDREN WITH APLASTIC CRISIS: |
NO RASH!!!!! usually!!!!
Prodromal illness: Fever Myalgia Lethargy N/V ABDOMINAL PAIN |
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ERYTHEMA INFECTIOSUM (FIFTH DISEASE)
SICKLE CELL DISEASE |
May have concurrent vasoocclusive crisis!!!!
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ERYTHEMA INFECTIOSUM (FIFTH DISEASE)
THERAPEUTIC MANAGEMENT AND COMPLICATIONS!!! |
Supportive:
Antipyretics Analgesics Antiinflammatory Possible blood transfusion for TRANSIENT APLASTIC ANEMIA |
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ERYTHEMA INFECTIOSUM (FIFTH DISEASE)
COMPLICATIONS: |
Self-limited arthritis and arthralgia
(arthritis may become chronic!!) - more common in ADULT WOMEN May result in SERIOUS COMPLICATIONS: Anemia Hydrops Fetal death if mother infected during pregnancy (normally SECOND TRIMESTER) APLASTIC CRISIS in children with HEMOLYTIC DISEASE or immunodeficiency MYOCARDITIS!!!! RARE!!!!! |
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ERYTHEMA INFECTIOSUM (FIFTH DISEASE)
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Isolation of children is NOT NECESSARY
EXCEPT: Hospitalized child (immunosupressed or with aplastic crisis) suspected of HPV infection placed on RESPIRATORY AND STANDARD PRECAUTIONS!!! |
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ERYTHEMA INFECTIOSUM (FIFTH DISEASE)
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Pregnant women NEED NOT be excluded from workplace where HPV is present; but they should NOT CARE for patients with APLASTIC CRISIS
Explain LOW RISK OF FETAL DEATH to those in contact with affected children; assist with routine FETAL ULTRASOUND for detection of FETAL HYDROPS |
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EXANTHEM SUBITUM (ROSEOLA INFANTUM)
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Agent: Human herpesvirus type 6 (HHV-6; rarely HHV-7)
Source: Possibly acquired from SALIVA of healthy adult person Entry: Nasal, Buccual, or conjunctival mucosa Transmission: YEAR ROUND; no reported contact with infected individual in most cases (virtually limited to THREE YEARS OLD but peak age is 6-15 MONTHS) INCUBATION PERIOD: Usually 5-15 days PERIOD OF COMMUNICABILITY: UNKNOWN |
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EXANTHEM SUBITUM (ROSEOLA INFANTUM)
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Persistent high fever for 3-4 days, in child who APPEARS WELL
Preciptious drop in fever to normwal with APPEARANCE OF RASH RASH: Discrete rose-pink maculus or maculopapules appearing FIRST ON TRUNK THEN spreading to NECK, FACE AND EXTREMITIES NO ITCHING FADES ON PRESSURE; LASTS 1-2 DAYS |
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EXANTHEM SUBITUM (ROSEOLA INFANTUM)
ADDITIONAL SIGNS AND SYMPTOMS: |
Cervical and postauricular lymphadenopathy
Inflamed pharynx Cough Coryza |
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EXANTHEM SUBITUM (ROSEOLA INFANTUM)
THERAPEUTIC MANAGEMENT |
ANTIPYRETICS TO CONTROL FEVER
Complications: RECURRENT FEBRILE SEIZURES (possibly from latent infections of CNS that is reactivated by fever) ENCEPHALITIS (RARE) |
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EXANTHEM SUBITUM (ROSEOLA INFANTUM)
PARENT TEACHING |
Teach parents measures for lowering temperature; specific antipyretic dosage
Discuss appropriate precautions and possibility of recurrent febrile seizures |
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MEASLES (RUBEOLA)
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Agent: Virus
Source: Respiratory tract secretions, BLOOD, URINE of infected person Transmission: Usually DIRECT contact with droplets of infected person; primarily WINTER Incubation period: 10-20 days Period of Communicability: From 4 days to 5 days after rash appears but mainly during PRODROMAL CATARRHAL STAGE) |
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MEASLES (RUBEOLA)
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Prodromal:
Fever and malaise followed IN 24 HOURS by CORYZA, cough, conjunctivitis, KOPLIKE SPOTS (small, irregular, red sponts with a minute BLUISH white enter first seen on BUCCAL MUCOSA opposite MOLARS 2 DAYS BEFORE RASH SYMPTOMS GRADUALLY INCREASE IN SEVERITY UNTIL SECOND DAY AFTER RASH APPEARS THEN SUBSIDES |
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MEASLES (RUBEOLA)
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RASH:
Appears 3-4 days after onset of prodromal stage Begins as erythematous maculopapular eruption on face and gradually spreads DOWNWARD; more severe in earlier sites (confluent) and less intense in later sites (appears discrete) After 3-4 days assumes brownish appearance and FINE DESQUAMATION |
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MEASLES (RUBEOLA) - VACCINE GIVEN AT 12-15 MONTHS
SECOND MEASLES GIVEN AT 4-6 YEARS OF AGE REVACCINATION AT 11-12 YEARS IF NOT GIVEN AT SCHOOL ENTRY BORN BEFORE 1956 IMMUNE |
S/S:
Anorexia Abdominal pain Malaise Generalized lymphadenopathy |
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MEASLES (RUBEOLA)
DURING OUTBREAKS, VACCINES CAN BE GIVEN AFTER 6 MONTHS OF AGE; FOLLOWED BY SECOND AFTER 12 MONTHS OF AGE ANY CHILD VACCINATED BEFORE 12 MONTHS SHOULD RECEIVE TWO ADDITIONAL DOSES BEGINNING AT 12-15 MONTHS SEPARATED BY 4 WEEKS |
Preventive:
Childhood immunization Vitamin A supplementation Supportive: BED REST during febrile period; antipyretics ANTIBIOTICS to prevent secondary bacterial infections in high-risk children |
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MEASLES (RUBEOLA)
SUSCEPTIBLE IMMUNOCOMPROMISED AND YOUNG ADULTS IDENTIFY AND IMMUNIZE IF TWO DOSES WERE NOT PREVIOULY GIVEN OR IF CONFIRMED CASE OF ILLNESS |
COMPLICATIONS:
Otitis Media Pneumona (bacterial) Obstructive laryngitis and laryngotracheitis Encephalitis (rare but has high mortality!!!) |
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MEASLES (RUBEOLA)
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Maintain ISOLATION until 5th day of rash; if child
is HOSPITALIZED, institute DROPLET precautions REST during PRODROMAL: quiet activity Fever: antipyretics, avoid chilling Seziures: If child is prone to, institute precautions Eye are: Dim lights if photophobia present Clean eyelids with warm saline solution to remove seretions or crusts, keep child from rubbing eyes CORYZA, COUGH: Use cool-mist vaporizer; protect skin around nares with vasoline, encourage fluids and soft BLAND foods Skin care: Keep clean; use tepid baths as necessary |
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MUMPS
Vaccine given at 12-15 months of age; combination with measles and rubella. DO NOT GIVE BEFORE 12 MONTHS OF AGE D/T MATERNAL ANTIBODIES ALL PEOPLE BORN AFTER 1957 |
Agent: PARAMYXSOVIRUS
SOURCE: Saliva of infected persons Transmission: Direct contact with or droplet spread from an infected person Incubation period: 14-21 days Period of communicability: Most communicable immediately before and after swelling bgins |
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MUMPS (PARAMYXOVIRUS)
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Fever, headache, malaise and anorexia for 24 hours FOLLOWED BY EARACHE that is aggravated by chewing
PAROTITIS: By third day; parotid glands (either unilater or bilateral) enlarges and reaches maximum size in 1-3 days; accompanied by PAIN/TENDERNESS |
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MUMPS (PARAMYXOVIRUS)
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Preventive: Childhood immunization
Supportive: Antipyretics/analgesics for feverr IV FLUIDS for child who refuses to drink or vomits d/t meningoencephalitis COMPLICATIONS: Sensorineural deafness Postinfectious encephalitis Myocarditis Arthritis Hepatitis Epididymoorchitis Oopharitis Pancreatitis Sterility (extremely rare in adult males) Meningitis |
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MUMPS (PARAMYXOVIRUS)
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Maintain ISOLATION during period of communicability
Hospitalization: DROPLET CONTACT Encourage rest and decreased activity during prodromal phase until swelling subsides Analgesics for PAIN, if child unable to swallow pills, use elixir Encourage fluids, soft BLAND foods, avoid foods requiring chewing HOT/COLD COMPRESSES TO NECK To relieve orchitis: provide WARMTH and local support with tight fitting underpants |
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PERTUSSIS (WHOOPING COUGH)
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Agent: Bordetella pertussis
Source: Respiratory tract infected persons Catarrhal stage: Begins with symptoms of : URTI such as coryza, sneezing, lacrimation, cough, low-grade fever, symptoms continue for 2 weeks then dry hacking cough becomes more severe |
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PERTUSSIS (WHOOPING COUGH)
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Preventive:
Immunization, current belief is that childhood immunizations for pertussis do not confer lifelong immunity to adolscents and adults; therefore a pertussis BOOSTER is recommended for adolescents ISOLATION DURING CATARRHAL STAGE; IF HOSPITALIZED DROPLET PRECAUTIONS TRANSMISSION: Direct contact or droplet spread from infections person; INDIRECT CONTACT with freshly contaminated articles INCUBATION PERIOD: 6-20 DAYS; USUALLY 7-10 DAYS Period of communicability: Greatest during catarrhal stage before onset of paroxysms |
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PERTUSSIS (WHOOPING COUGH)
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Paroxysmal Stage:
Cough most common at night (short, rapid coughs followed by sudden inspriation with high pitched crowing sound or whoop: during paroxysms, cheeks become flushed or cyanotic, eyes bulge, and tongue protrudes; paroxysm may continue until thick mucous plug is dislodged; vomiting frequently follows attack; stage generally lasts 4-6 weeks, followed by convalescent stage |
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PERTUSSIS (WHOOPING COUGH)
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INFANTS under 6 months MAY NOT have characterisitc whoop cough but have difficu;ty maintaining adequate oxygenation with amount of secretions, frequent vomiting of mucus and formula or breast milk
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PERTUSSIS (WHOOPING COUGH)
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may occur in adolescents/adults; cough/whoop may be absent, however, as many as 50% of adolescents may have a cough for up to 10 weeks, difficulty breathing and posttussive vomiting
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PERTUSSIS (WHOOPING COUGH)
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Antimicrobial therapy:
ERYTHROMYCIN CLARITHROMYCIN AZITHROMYCIN Supportive: Hospitilization sometimes required for infants, children who are dehydrated Increased oxygen and humidity Fluids!!! Intensive care and mechanical vent if needed UNDER 6 MONTHS |
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PERTUSSIS (WHOOPING COUGH)
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COMPLICATIONS:
Pneumonia (usual cause of death in younger children) Atelectasis Otitis media Seizures hemorrhage (scleral, conjunctival, epistaxis, pulmonary hemorrhage in neonate Weight loss/dehydration Hernias (umbilical and inquinal) Prolapsed rectum Complications ADOLESCENTS: Syncope Sleep disturbance Rib fractures Incontinence Pneumonia |
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Nursing Care Management - PERTUSSIS
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1) Obtain nasopharyngeal culture
2) Encourage oral fluids; offer small amount of fluids frequently 3) Adequate oxygenation during paroxysms; position infant ON SIDE to decrease chance of aspiration with vomiting 4) Humidified oxygen; suction as needed 5) Observe for signs of AIRWAY OBSTRUCTION (increased restlessness, apprehension, retractions, cyanosis) 6) Encourage compliance with ANTIBIOTIC THERAPY for household contacts 7) Encourage ADOLESCENTS to obtain PERTUSSIS BOOSTER 8) STANDARD PRECAUTIONS/MASK HEALTHCARE WORKERS |
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POLIOMYELEITIS
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Agent:
ENTEROVIRUSES (3 TYPES) Type 1: most frequent cause of PARALYSIS, both epidemic and endemic Type 2: LEAST FREQUENT associated with paralysis Type 3: SECOND MOST associated with paralysis SOURCE: FECES and OROPHARYNGEAL secretions of infected persons; especially young children TRANSMISSION: Direct contact with persons with apparent or inapparent active infection; spread via fecal-oral and pharyngeal-oropharyngeal routes Vaccine-acquired paralytic polio may occur as a result of the LIVE oral polio vaccination (no longer available US) |
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POLIOMYELEITIS
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Incubation period: usually 7-14 days with range of 5-35 days
Period of Communicability: Not known, VIRUS present in throat and feces shortly after infection - persists for 1 week in throat; 4-6 weeks in feces |
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POLIOMYELEITIS
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May manifest in THREE different forms:
ABORTIVE OR INAPPARENT: Fever, uneasiness, sore throat, headache, anorexia, vomiting, abdominal pain lasts a few hours to a few days NONPARALYTIC: Same as abortive but more severe, with PAIN, STIFFNESS in NECK, BACK AND LEGS PARALYTIC: Initial course similar to nonparalytic type followed by recovery and then signs of CENTRAL NERVOUS SYSTEM PARALYSIS |
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POLIOMYELEITIS
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Preventive: Childhood immunization
Supportive: Bed rest during acute phase Mechanical or assisted vent in case of respiratory paralysis Physical therapy for muscles after acute stage COMPLICATIONS: PERMANENT PARALYSIS Respiratory arrest Hypertension Kidney stones from demineralization of bone during immobility |
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POLIOMYELEITIS
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Administer mild sedatives (relieve anxiety/promote rest)
Physiotherapy (moist hot packs/ROM) Position child to maintain body alignment and prevent contractures or skin breakdown; use footboard or appropriate orthoses to prevent footdrop; pressure mattresses for prolonged immobility Encourage child to perform ADLs to capability; promote early ambulation Administer analgesics HIGH PROTEIN DIET BOWEL MANAGEMENT OBSERVE FOR RESPIRATORY PARALYSIS -Difficulty talking -Ineffective cough -Inability to hold breath -Shallow/rapid respirations |
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RUBELLA (German Measles) - RUBELLA VIRUS
MILD IN CHILDREN PREGNANT WOMEN - SERIOUS RISKS FETUS AIM OF RUBELLA IMMUNIZATION: PROTECTION OF THE UNBORN CHILD |
Agent: Rubella virus
Source: Nasopharyngeal secretions of persons with apparent or inapparent infection Also present in BLOOD, STOOL, URINE Incubation period: 14-21 days Period of communicability: 7 days before to about 5 days after appearance of rash LOW GRADE FEVER HEADACHE MALAISE LYMPHADENOPATHY |
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RUBELLA (German Measles) - RUBELLA VIRUS
RUBELLA VACCINE - 12 TO 15 MONTHS OF AGE COMBINATION WITH MUMPS/RUBELLA DO NOT GIVE VACCINE TO PREGNANT WOMEN!!!! |
PRODROMAL STAGE:
Absent in children present in adults/adolscents - low grade fever, headache, malaise, anorexia, mild conjunctivitis, coryza, sore throat, cough and lymphadenopathy lasts 1-5 days, SUBSIDES 1 DAY AFTER APPEARANCE OF RASH |
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RUBELLA (German Measles) - RUBELLA VIRUS
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RASH:
First appears on face and rapidly spreads DOWNWARD to NECK, ARMS, TRUNK,"", AND LEGS by end of first day body is covered with discrete, pinkish red maculopapular exanthema; disappears in same order as it began and is usually gone by third day |
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RUBELLA (German Measles) - RUBELLA VIRUS
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Preventive:
Childhood immunization NO TREATMENT NECESSARY other than ANTIPYRECTIS for low grade fever and ANALGESICS for discomfot |
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RUBELLA (German Measles) - RUBELLA VIRUS
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COMPLICATIONS (RARE)
Arthritis Encephalitis Purpura MOST BENIGN OF ALL CHILDHOOD COMMUNICABLE DISEASES GREATEST DANGER IS TERATOGENIC EFFECT ON FETUS |
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RUBELLA (German Measles) - RUBELLA VIRUS
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Reassure parents of benign nature of illness in affected child
Comfort measures NO CONTACT PREGNANT WOMEN Monitor RUBELLA TITER in pregnant adolescent |
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SCARLET FEVER
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Agent: Group A B hemolytic streptococci
Source: Usually from nasopharyngeal secretions of infected persons and carriers Transmission: DIRECT contact with infected person or DROPLET spread INDIRECTLY by contact with contaminated articles or INGESTION of CONTAMINATED MILK OR OTHER FOOD INCUBATION PERIOD: 2-5 days, with range of 1-7 days Period of Communicability: During incubation period and clinical illness approximately 10 days; during first 2 weeks of carrier phase, although may persist for months |
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SCARLET FEVER
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PRODROMAL STAGE:
Abrupt HIGH FEVER, pulse INCREASED out of proportion to fever Vomiting, headache, chills, malaise, abdominal pain, halitosis ENANTHEMA: Tonsils enlarged, edematous, reddened and covered with patches of exudates, in severe cases apparance resembles membrane seen in diptheria; pharynx is edematous and BEEFY RED; during first 1-2 days TONGUE is coated and papillae become red and swollen (WHITE STRAWBERRY TONGUE) by 4th or 5th day WHITE COAT SLOUGHS OFF, leaving prominent papillae (RED STRAWBERRY TONGUE); palate is covered with erythematous punctate lesions EXANTHEMIA: Rash appears within 12 hours after prodromal signs: red pinhead sized punctate lesions rapidly become generalized but are ABSENT on face which becomes FLUSHED with striking circumoral pallor; RASH most intense in folds of JOINTS; BY END OF FIRST WEEK DESQUAMATION BEGINS (FIND, SANDPAPER-LIKE on torso; sheetlike sloughing on palms and soles |
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SCARLET FEVER
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Treatment:
Full course of PENICILLIN (OR ERYTHROMYCIN IN penicillin sensitive children or ORAL CEPHALOSPORIN Antibiotic therapy for newly diagnosed carriers (nose/throat cultures positive for streptococci Supportive: Rest during febrile phase Analgesics for sore throat Antipruritics for rash if bothersome |
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SCARLET FEVER
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Complications:
Peritonsillar and retropharyngeal abscess Sinusitis Otitis Media Acute glomerulonephritis Acute rheumatic fever polyarthritis |
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SCARLET FEVER
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STANDARD AND DROPLET PRECAUTIONS until 24 hours after initiation of treatment
Compliance with oral antibiotic therapy; IM benzathine penicillin G (Bicillin) Rest; quiet Sore throat; analgesics, gargles, lozenges, antiseptic throat sprays and inhalation of cool mist |
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SCARLET FEVER
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Encourage fluids during febrile phase
Avoid irritating liquids (citrus juices) or rough food (chips) Begin with soft diet Prevent spread of infection - discard toothbrushes |
