Children's Health

Bacterial and Viral Rashes

Roseola infantum

Roseola is also called exanthem subitum and is a common childhood virus caused by the human herpesvirus 6 or 7. The disease usually occurs in children younger than 4 years.

• Symptoms
  • The symptoms are a high, spiking fever for up to 8 days followed by the onset of a rash.
  • The rash is small, pink, flat, or slightly raised lesions that appear on the trunk and spread to the extremities.
• Treatment
  • Despite the worrisome fever, the disease is not harmful and gets better without specific therapy. Fever can be managed with acetaminophen. Aspirin and aspirin-like products should ALWAYS be avoided in children as it can cause a life-threatening condition called Reye syndrome.
  • The fever, especially if it rises rapidly, may result in a “febrile” seizure in susceptible children.

Coxsackieviruses and other enteroviruses

The enteroviruses, including the coxsackieviruses, are a very common cause of fever and rash in children. Two diseases are caused by coxsackieviruses, called hand-foot-and-mouth disease and herpangina. Coxsackievirus infections are more common in the summer and autumn.

• Symptoms
  • In hand-foot-and-mouth disease, the children develop fever and rash. The rash includes blisters to the mouth and tongue and to the hands and the feet.
  • Herpangina (not caused by a “herpes” virus) causes a fever, sore throat, and painful blisters or ulcers on the back of the mouth that cause difficulty swallowing. Children may also have loss of appetite, abdominal pain, headaches, and joint pain.
• Treatment
  • No specific treatment is available except acetaminophen (Tylenol) or ibuprofen (Advil) for fever. Aspirin and aspirin-like products should ALWAYS be avoided in children as it can cause a life-threatening condition called Reye syndrome.
  • The diseases are not harmful but can be prevented with good hand washing and not eating off someone else's plate or sharing straws.

Impetigo

Impetigo is a superficial skin infection with streptococcal or staphylococcal bacteria. It is often found around the nose and mouth but can occur anywhere. The rash is more common in the warmer months. It can also be an additional infection of skin that has been damaged, such as in scabies, poison ivy, eczema, or drug reactions.

• Symptoms
  • Impetigo begins as small superficial blisters that rupture leaving red, open patches of skin.
  • Often a honey-colored crust forms over this rash.
  • The rash is very itchy.
  • Impetigo is also highly contagious. A child can spread the infection to other parts of the body or to other people.
• Treatment
  • This infection of the skin is easily treated with topical or oral antibiotics and washing the skin with antibacterial soap.
  • Your child usually is no longer contagious after 2-3 days of therapy, and the rash begins to heal in 3-5 days.
  • If the rash does not show signs of healing by the third day of treatment, or if it is spreading, your child needs to be seen by your doctor.
  • When the impetigo occurs in addition to poison ivy or scabies, your child may benefit from an anti-itch medication while the antibiotics are taking effect.