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Developed fever. Had slight bilateral rash on face head, neck, torso, back and legs. Appetite poor. What can be done?

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My 9 month old healthy, full term, immunized son developed a sudden-onset fever reaching ~103 +/- for about three days. On the third day he had a slight bilateral rash on his face and by the morning of the fourth day he had no fever but has a slightly raised, seemingly macopapular rash on his face, head, neck, torso, back and at the top of his legs. His eyes are slightly puffy and a bit reddish and although he no longer has a fever he's still pretty cranky. His apetite is poor but he does take fluids. His sleep is disturbed both for naps and night time. He's, of course, clingy and without even a 9 month old patience level. Being a nurse I believe it's roseola but was told it's most likely fifth disease. The onset and symptomology don't really fit fifth disease to my way of thinking and although his face sort of looks like it's been slapped it was never just red like a slapped face, it started with a rash-- haven't checked if it blanches or if his glnads are swollen. I realize there's not much to be done except keep him cool and comfortable but it bothers me not to know. Thank you so much.
Posted Tue, 9 Jul 2013 in Child Health
 
 
Answered by Dr. Rajiv K Khandelwal 21 minutes later
Hi,

Thank you for your query.

I can understand your anxiety. However I would like to have the following information to guide you further:
1. Is today is the fourth day following the fever?
2. Is the rash still persisting? Has there been any reduction in the rash?
3. Have any investigations been done?
I shall appreciate if you can upload a photograph of the rash using the facility on this platform.

By description and symptoms it is very difficult to provide a diagnosis as a number of viral infections present with rash following fever. Children do become cranky following illness and shall take some time (about a week) to settle down to their normal routine.

You have rightly said that nothing much has to be done except to keep your son comfortable which you are doing.

I hope I have answered your query to your satisfaction. Please feel free to revert back in case you need any clarifications or would like to share more facts.

Wishing your son an early recovery.

Regards,

Rajiv K Khandelwal
http://goo.gl/SuCjl
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Follow-up: Developed fever. Had slight bilateral rash on face head, neck, torso, back and legs. Appetite poor. What can be done? 21 hours later
Hello,

Thank you for your reply. I sent photo's, did you receive them? I have more prn.

Wednesday, XXXXXXX 19th, was the third day. He awoke from a nap in my arms with one bright red rashy cheek where it connected with my arm and the other cheek slightly red. He still had a fever. The next morning, Thursday, he awoke without a fever but with a rash over his face, neck, head, torso, back and a bit on his legs. The rash fades a bit but becomes bright/exaggerated when he's hot or crying. He has no fever but he's still not himself. Tylenol helps as he seems to feel poorly but not terribly sick. I have not taken him to his pediatrician so no diagnostics have been done. Pretty sure it's viral and do not want to subject him to unnecessary tests...but, of course, I will take him instantly if this is something XXXXXXX
 
 
Answered by Dr. Rajiv K Khandelwal 3 hours later
Hi,

Thank you for the updates and the photographs.

Apart from the diagnosis which you are thinking I will put measles in the differential diagnosis. Unfortunately the pathognomic sign of measles, Koplik spots in the oral cavity, last only for a few hours and then disappear around the time the rash appears.

As the fever has subsided, it shall take a few days for the rash to disappear. You continue managing him as you are doing. As he is on the road to recovery nothing else needs to be done at this stage. For academic purpose we can get investigations done.

Please feel free to revert back in case you need any clarifications.

Wishing your son an early recovery.

Regards,

Rajiv
Above answer was peer-reviewed by
 
Follow-up: Developed fever. Had slight bilateral rash on face head, neck, torso, back and legs. Appetite poor. What can be done? 2 hours later
Thank you, I will look into this as it could be a problem with our 3 month old.
 
 
Answered by Dr. Rajiv K Khandelwal 10 minutes later
Hi,

Thank you for your update.

It is very unusual for a 3 month child to have measles. The most common age is after 6-9 months of age.

Wishing you all the best.

Regards,

Rajiv

P.S.: In case you intend closing the query then please do give your feedback.

Rajiv
Above answer was peer-reviewed by
 
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