Presentation on theme: "THE CHILD WITH A SKIN RASH key points for approach dr Gerlant van Berlaer Pediatric section of the Department of Emergency and Disaster Medicine UZ Brussel."— Presentation transcript:
THE CHILD WITH A SKIN RASH key points for approach dr Gerlant van Berlaer Pediatric section of the Department of Emergency and Disaster Medicine UZ Brussel
Quiz Only 3 possible answers 1) not okay 2) okay 3) don’t know 2 2-4-2015 het kind met vlekjes
Ill children are ‘not okay’ Parents: More worried than usual: “ this is not my child ” or “ my child is different than otherwise when sick ” Signals of: serious bacterial infection Meningitis Dehydratation
Not okay criteria I age < 3 months fever >3 days, ‘high’ fluid balance: less drinking dry diapers vomiting /diarrhea general physical examination: fast, weak pulse tachypnea
Not okay criteria II behaviour: crying: continuously, not able to comfort weak, grinding Consciousness: apathic, lethargic, somnolent ‘beware of the quiet baby’
Not okay criteria III Neurological: Meningeal irritability (‘diaper pain’!) Convulsions typical hyperthermic convulsions Skin: colour: pale, spotted, grey, cyanotic, marbled Skin rash: May be transient May be transient petechiae [under nipples, extremities, pressured spots] petechiae [under nipples, extremities, pressured spots] blanket away, clothes off, diaper open!
Flowchart questions in case of rash Sick? Vesicles? (hairy scalp, palms & soles, age, mouth, intake) Bullae? (mechanical, burns) Skin spots? Colour? Congenital? Coherent history with lesions? Child abuse? Travels? Pruritus? Skin dihescence? Petechiae? Petechiae? Localisation? Vaccinations? Contaminated? Recently ill? Associated symptoms? Drug use? titel 7 2-4-2015
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