PEDIATRICS
TREATMENT
■ Primarily supportive, with antihistamines
■ Oral acyclovir can be considered for young infants <6 months, children
on oral/inhaled steroids, children presenting within 24 hours of onset of
rash or high fevers.
■ Immunosuppressed children require IV acyclovir and hospitalization.
COMPLICATIONS
Rare but may include encephalitis, pneumonia, hepatitis, bacterial superinfec-
tion, Reye’s syndrome, and group A streptococcal sepsis or necrotizing fasciitis
Other Common Pediatric Infections Presenting to the ED
HAND-FOOT-MOUTHDISEASE
■ Causative agent is coxsackievirus A16
■ Transmission by fecal-oral route
■ Peak incidence summer and early fall
SYMPTOMS/EXAM
Brief prodrome of low-grade fever, pharyngitis, and malaise followed in 24–48
hours by oral ulcers (usually posterior pharyngeal) and erythematous macular
and/or vesicular rash occurring predominantly on the palms and soles
DIAGNOSIS
Clinical diagnosis; termed herpangina if only oral lesions are present
TREATMENT
Supportive care
MUMPS
Caused by an RNA virus in the Paramyxoviridae family; humans are only
known natural hosts
SYMPTOMS/EXAM
■ Painful swelling of one or more salivary glands (parotid most commonly)
■ Fever
■ Weakness and fatigue
DIAGNOSIS
■ Clinical diagnosis
■ Diagnosis is confirmed by viral culture of throat washing, saliva, spinal
fluid, or urine, or by serologic testing (IgM antibody, or acute and conva-
lescent sera for IgG)
TREATMENT
Supportive