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Child has raspy voice, body rash, no fever. What could it be?

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Hello - My 5 month old has had a raspy, hoarse voice on and off for a month and a half now with no other symptoms (other than two separate body rashes but they seem unrelated - our pediatrician and an allergist believe the rashes to be contact dermatitis). This morning he woke up with an incredibly hoarse voice and can barely make a sound and when he does it is a high pitched, strained noise. He can't really cry - just squeals. He doesn't have a fever or any other symptoms and seems happy. Feeding ok. Drooling but doesn't seem more than usual. What could it be? Should we be worried about his breathing? We slept at my in-laws house last night and it was very dry but can dryness alone cause such an extreme hoarse voice? It is awful to listen to. Help!
Posted Mon, 21 May 2012 in Child Health
 
 
Answered by Dr. Santosh Kondekar 4 hours later
Hi XXXXXXX

this can well be an acute viral laryngitis and can recover in 7 days. emergency arises only when child can't feed or breath comfortably or has continuous drooling or high fever. In such cases visiting an emergency department is must to rule out acute epiglottitis.
In addition such issues are seen with low body calcium and laryngotracheomalacia (soft larynx due to other reasons). its not related to dryness.

provision of sound clip will be useful to be precise. The rashes may be apart of atopic eczema at this age.

do ask a question if any issue is less understood.
thanks
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Follow-up: Child has raspy voice, body rash, no fever. What could it be? 12 hours later
Thank you!
Two questions - what are some other signs/symptoms of calcium deficiency? Assuming the only way to know for sure is a blood test? I have celiac disease and often worry that not enough nutrients are getting through to my breast milk.

Do you have any suggestions for treatment of the rash/eczema? We have tried cortisone creme which is not working, nor is just plain vaseline.

Thank you!!
XXXXXXX
 
 
Answered by Dr. Santosh Kondekar 25 hours later
Hi XXXXXXX
Thanks for writing back.

Calcium deficiency in children can be asymptomatic but can lead to lethargy, difficulty feeding, vomiting, abdominal distension, seizures, twitching or laryngospasm (rarely)
The diagnosis is usually made by taking a complete history and correlating it with blood work. Breast milk usually has sufficient nutrients to XXXXXXX the requirements of your children, irrespective of the fact that you have Celiac's disease. You need not worry on that front.

For the treatment of the rash, I would suggest the following:
a. Bathe your child in lukewarm water for 5 minutes and put vaseline while his skin is still damp. This will help seal in the moisture.
b. If your child is not responding to applcation of cortisone ( which needs to be put twice a day), I would suggest you see his paediatrician for a stronger steroid like triamcinolone or betamethasone. These will help take care of his symptoms. However, the steroids need to be discontinued as soon as the symptoms disappear.

Hope this helps.
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Follow-up: Child has raspy voice, body rash, no fever. What could it be? 2 hours later
Thanks so much!! Very helpful. Our pediatrician is sending him to an ear/nose/throat doctor to investigate his hoarse voice further.
Thank you for taking the time to respond and we will try your tips re: rash.
 
 
Answered by Dr. Santosh Kondekar 44 minutes later
hi again
sorry for late, but here are the answers to your questions.
- what are some other signs/symptoms of calcium deficiency?
symptoms: jitteriness, shakiness, tremulousness
signs: prominent chest bones, altered or husky voice,tetany, convulsions
All need not be in all patients. At this age, possibility of calcium deficiency will conclude the likelihood of mother being calcium deficient too. Often vitamin D deficiency coexists.

Assuming the only way to know for sure is a blood test?
== true, but a simple test like Troussaue test can be done to conclude the calcium deficiency without any blood work.

I have celiac disease and often worry that not enough nutrients are getting through to my breast milk.
=== Its good idea to supplement at this age.

Do you have any suggestions for treatment of the rash/eczema?
== rashes are of various types. many times parents try a lot of things before writing to me. The medicines for rashes need not be safe all the time.Rashes are best treated by understanding the state at present with evidence of infection and allergy. If the infection is likely, then steroids may worsen the situation. you may post a pic of rash for detailed evaluation.

Thank you. Do write back .
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