What's Going Around?

Allergies

Seasonal allergies, or hayfever, are very common at this time of year. Typical symptoms include watery, itchy, red eyes; a clear runny nose; sneezing; and an itchy palate or throat. The most common triggers are trees in the spring, grasses in the summer, and weeds in the fall!

Effective non-sedating medications are now available for children over the age of 2 without a prescription for treatment of seasonal allergies. These include loratadine (generic Claritin), Claritin, and Zyrtec. These medications can be given as needed for allergy symptoms. If you think your child has seasonal allergies and he or she is not responding to medication OR if you are not sure, please make an appointment in our office.

Many children do not require allergy testing if they respond to treatment with medication as needed.

For more information: See also Eye - Allergy


Colds and Upper Respiratory Infections

Colds, upper respiratory infections, and URIs are common terms we use to describe viral illnesses that cause nasal congestion, runny nose, sneezing, sore throat, fever, and cough. The fever usually lasts for 2-3 days, and the cough with congestion and runny nose may last for 5-10 days. The typical preschool-age child may experience 6-10 colds per year. Most colds resolve on their own with rest and fluids, but some may lead to ear infection, sinus infection, asthma attack, or other complications. If you are concerned about the possibility of one of these complications, please have your child seen in our office for an evaluation.

For more information: See also Colds , See also Sinus Pain or Congestion


Cough

We are currently seeing children and adolescents with cough, typically one of the most prominent and bothersome symptoms of viral respiratory infections at this time of year. Coughing is an important and beneficial reflex that our bodies need to clear secretions and to keep open our major airways during the course of a viral cold or upper respiratory infection. However, severe or persistent cough can be associated with asthma, pneumonia, sinus infections, and bronchiolitis, and should be evaluated by your health care provider.

For more information: Previous diagnosis of asthma, see Asthma Attack , If you are coughing because of an Asthma Attack, see Asthma Attack , Any Chest Pain , If you have a Common Cold, see Colds , See also Colds , See also Cough , Barky cough and hoarseness, see Croup , If Earache is your main concern, see Earache , Wheezing but no previous diagnosis of asthma, see Wheezing (Other Than Asthma)

SORE THROATS

SORE THROATS
VIRAL AND OTHER CAUSES
  • Colds.Most sore throats are part of a cold. In fact, a sore throat may be the only symptom for the first 24 hours. Then a cough and runny nose occur.
  • Viral Pharyngitis.Some viruses cause a sore throat without other symptoms. A cough and runny nose don't always become part of the illness. An antibiotic won't help.
  • Mono.Infectious Mono mainly occurs in teens and young adults. The main symptoms are sore throat, fever and widespread swollen lymph nodes. Like Strep, Mono also has pus on the tonsils. Patients with Mono also may have a large spleen. It's located in the upper left side of the stomach. Mono is diagnosed with special blood tests.
  • Post-nasal Drip.Drainage from a sinus infection can cause a sore throat. The throat clearing that goes with the drainage may cause most of the irritation. The sinus infection is more likely to be viral than bacterial.
  • Mouth Breathing.Breathing with the mouth open during sleep can cause a sore throat. After eating breakfast, it often goes away.
  • Abscess of Tonsil (Serious).A bacterial infection of the tonsil can spread to the surrounding tissues. The main symptoms are severe trouble swallowing, fever and one-sided throat pain. Often one tonsil is much bigger/more inflamed and more painful than the other. It's also hard to fully open the mouth. The peak age is teens.
  • Epiglottitis (Very Serious).A bacterial infection of the flap of tissue above the vocal cords. It normally covers the windpipe during swallowing. The main symptoms are severe sore throat, drooling, spitting and fever. It can shut off the airway. Needs a 911 response. Fortunately this is rare since introduction of the HIB vaccine (Heamophilus Influnza B).
STREP THROAT
  • Symptoms include sore throat, fever, headache, stomach pain, nausea and vomiting.
  • Cough, hoarseness, red eyes, and runny nose are usually not seen with Strep throat. These symptoms point more to a viral cause.
  • Scarlet fever rash (fine, red, sandpaper-like rash) is highly suggestive of Strep throat.
  • Peak age: 5 to 15 years old. Not common under 2 years old unless sibling has Strep.
  • If you think your child has Strep, call your doctor.
  • Your doctor will do a Strep test. If the test is positive, they will start treatment. There is no risk from waiting until a Strep test can be done.
  • Standard treatment is with antibiotics by mouth.
When and Whom To Call For Sore Throats
CALL 911
  • Severe trouble breathing (struggling for each breath, can barely speak or cry)
  • You think your child has a life-threatening emergency
Call Doctor or Seek Care Now
  • Trouble breathing, but not severe
  • Great trouble swallowing fluids or spit
  • Can't open mouth all the way
  • Stiff neck or can't move neck like normal
  • Dehydration suspected. No urine in more than 8 hours, dark urine, very dry mouth and no tears.
  • Purple or blood-colored spots or dots on skin
  • Weak immune system. Examples are: sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
  • Fever over 104° F (40° C)
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent. Note: a Strep test alone is not urgent.

Call Doctor Within 24 Hours
  • Sore throat pain is severe and not better 2 hours after taking ibuprofen
  • Large lymph nodes in the neck
  • Pink rash that's widespread
  • Earache or ear drainage
  • Fever lasts more than 3 days
  • Fever returns after being gone more than 24 hours
  • Age less than 2 years old
  • Close contact to a person with Strep within last 7 days
  • Sores on the skin
  • You think your child needs to be seen, but the problem is not urgent (or needs a Strep test)
Call Doctor During Office Hours
  • Sore throat is the main symptom and lasts more than 48 hours
  • Sore throat with cold/cough symptoms lasts more than 5 days
  • You have other questions or concerns





Source: adapted from Copyright 2000-2019 Schmitt Pediatric Guidelines LLC.