Children

There are so many childhood diseases, infectious and noninfectious, that it would be impossible to list them all here. However, we will introduce some of the most common ones, including viral and bacterial infections as well as allergic and immunologic illnesses.

A number of different viruses cause bronchiolitis (inflammation of the small airways), which affects children less than 1 year of age. Most commonly, it is caused by RSV (respiratory syncytial virus), but it can also be caused by influenza and other common viruses associated with upper respiratory symptoms such as fever, runny nose, and cough. A common symptom of bronchiolitis includes all of the above and wheezing (the same symptom observed in children with asthma). It is common in the winter months, and some infants will require admission to a hospital when the respiratory symptoms are very severe. The treatment of bronchiolitis is different from asthma; however, some of the same medications might be used. For a small percentage of infants, this first wheezing episode may be a harbinger of a future diagnosis of asthma, but for most, it is a onetime event.

Ear infections are very common in children and are caused by a dysfunction of the Eustachian tubes, the tubes that connect the inner ears to the throat and serve as a drain for any fluid that may collect there. When fluid collects, it attracts bacteria and other germs, which may multiply and cause a symptomatic infection. Symptoms include fever, ear pain, tugging on the ear, or even drainage from the ear canal. Treatment of ear infections may involve observation or antibiotics. Occasionally, the fluid inside the middle ear may need to be drained.

When fluid in the middle ear builds up and fails to clear up on its own or after treatment, it may need to be surgically drained. This procedure is called tympanocentesis. A needle is inserted into the middle ear and fluid is removed. Sometimes, because of recurrent infections or a chronic effusion (fluid that persists for at least three months), a tympanostomy tube may need to be inserted in the tympanic membrane (eardrum), which allows the middle ear to drain and function appropriately. The tubes remain in place and generally fall out by themselves after about a year. In most cases, the eardrum heals and functions normally after this procedure.

Croup is common in young children. A number of different viruses cause croup, and inflammation of the upper airways, including the larynx (voice box) and trachea (windpipe), cause symptoms. These symptoms include a barking cough and stridor, a wheeze on inspiration. Most children with croup can be treated at home, but occasionally, when severe enough, hospitalization may be required. Treatment may include steroids and inhaled medications for the more severe cases. Always check with your doctor if you are concerned or if your child appears ill.

Coxsackievirus causes hand, foot, and mouth disease. It is extremely common during the summer and early fall and resolves on its own after about 10 days. The virus causes fever, sore throat, and blisters inside the mouth, on the palms of the hands, and the soles of the feet. There is no medical treatment for the infection, except supportive care including pain relievers.

Pinkeye is also called conjunctivitis. A virus is the most common cause of pinkeye, but a bacterial infection can cause it on occasion. Pinkeye is very contagious and can spread through schools and day cares quickly. Always talk with a health-care professional to determine whether additional therapy is needed, but most cases resolve within five days.

A virus called parvovirus B19 causes fifth disease. This very common infection appears in the majority of children as a cold followed by a rash on the face and body. The typical description of the rash is a “slapped-cheek” appearance, since the rash is usually bright and appears as a reddish patch. The rash usually resolves within a week to 10 days. The only major risk of parvovirus is to pregnant women who have never been exposed to parvovirus in the past. There is a significant risk to the fetus for those individuals.

Rotavirus infection is responsible for significant morbidity and mortality in children in less developed countries where access to the rotavirus vaccine is limited. The infection causes significant fever, vomiting, and diarrhea in children. This can often lead to serious problems with dehydration, especially in very young children and infants. Before the introduction of the vaccine in the United States, rotavirus infection was a very common cause for hospital admission. Current studies indicate that the virus has resulted in up to 95% fewer admissions due to rotavirus infection to hospitals as result of vaccination.