Monday, June 21, 2010

Baby had a fever and severe rashes: allergy, chicken pox or roseola?

Hectic. That would be the word for the last 4 days. Waking up with Baby PP having a high fever one day and a body full of rash the next day. Regardless of the amount of information new parents have at their fingertips, a trip or two to the doctor is a must when situation like this occur. 

High fever of 38.2 degree made an appearance early in the morning.
The day before Mummylicious noticed a start of a fever and stayed home in hope it will not worsen. It "worsen". I woke up with a worry, told Daddylicious and we trooped to SDMC's emergency. Baby PP's pead was on holiday so the emergency doctor will have to do without a prior appointment with another peads. 

Baby PP looking sad at SDMC emergency.

Fever was confirmed at 38.2 degree celsius. A confirmed fever. Normal baby's temperature should be between 36 to 37 degree celcius and with Baby PP staying in air conditioned house is normally at 35.9 degree celsius. (Parents should be aware of baby normal temperature to know the difference). High temperature would be above 38.5 degree celcius. More in link below

SDMC emergency doctor checking Baby PP's mouth. Maybe it teething fever? 

But the doctor checked Baby PP and asked about vomiting, coughing, diarrhea, feeding and drinking habits. I could only answer, no to vomiting coughing diarrhea, baby PP is eating less but want more breastmilk, refusing regular plain water which she normally love. 

Since to the doctor, the fever is still considered mild, we were advised to get Baby PP to drink plain water no matter what, prescribed baby paracetamol and if the fever persisted at the same temperature the next day, another trip to the emergency is a must. That is all they could do.

Fever was lower than the day before. Still feverish but so long it is lower, it should be ok.
Noticed a couple of rash spots on Baby PP's abdomen but thought it was just a mild irritation. 

Woke up with Baby PP's abdomen and back full of little raised rashes. Must admit, I panicked a bit, called Daddylicious to come home from an exhibition in KL, got him to contact our family doctor straight and did online research. I was most worried about meningitis rash and no matter how prepared i was before, the readings i did about "when a parent should really worry about rashes", i forgotten everything! All i remember about meningitis was there will be fever and rash!

FYI meningitis rash will not be raised. It will be below the skin and look more like bruises. When presses, skin will not turn white but remain red or purple-blueish. 
"Use the glass test if your child has a rash and you suspect it could be meningitis. This is done by pressing a drinking glass firmly against the rash - if the spots don't fade through the glass, it could be meningococcal sepeticaemia, so call your GP immediately. If the spots fade away, the test is negative. But call your GP if you are worried."
Meningitis checklist for infants 
(meningitis rash is only one of the symptoms that might or might not appear)
(More links on Meningitis symptoms for babies and children at the bottom. I include it cause it is important to know and it is often misdiagnosed by *gasp doctors!)

Gave a deep sigh of relief after I poke Baby PP in the tummy and everywhere there were rashes to check if it turns white or remain the same even when i know raised rashes = not meningitis. One can never be too sure.

Once Daddylicious got back. We made a trip to see our family doctor to have a look at the rashes.

Roseola rash on baby chest and abdomen
Day 1: Baby PP's rash on her abdomen.  

Roseola rash around neck area
Day 1: Baby PP's rash behind her ears and on her neck

She concluded it could be 2 things. 

Allergic reaction

To what is unknown. the only new thing was given to Baby PP was pamelo fruit. and that is highly unallergy trigger! egg yolks was given too far back to be a cause and she had paracetamol before with no side effects.

Chicken pox
"this starts off with a few red spots or bumps (often mistaken for insect bites). Fever is common. The next day many more bumps will appear, and the first bumps will have turned into blisters. " AskDrSears
The doctor gave Baby PP antihistamine medication and with advise to see our regular pead on Monday if rash persist and to just let the pead know what is happening for the records.

If its allergic reaction, rashes will subside. Stop paracetamol just in case it was paracetamol allergy, no more egg yolks till a couple of weeks although the time frame of egg yolk allergy doesn't fit, no fish, no chicken, no new food...and no random table food. :P

If it is chicken pox, it will be worst. By day 3-4 the now flat rashes will be watery inside. To easily see, use a flashlight :) Then it is chicken pox and a trip to the peads is a MUST. if it is measles...which is doubtful due to MMR vaccination, definitely must see doc. My family doc dont think its chicken pox though cause it looks too much like measles but Baby PP is too happy to be "measly"

Day 1: Drugged out from the antihistamine

and this is how my little lady sleeps.

After my immense research about fever and rashes. I have to add a 3rd possible cause, one that is usually the last to be diagnosed but thankfully least harmful if it was not. Just a lot of Mummy being paranoid harm.

Roseola virus.
"It is a usually harmless illness caused by a virus. It occurs almost only in children age 3 months to 3 years, most often between 9-12 months. It is probably the most common cause of fever in this age group. This virus generally causes 3 days of high fever (often over 103). The fever then subsides, and the child breaks out in a flat or bumpy red rash, usually starting around the neck, back and chest, then spreading out. The rash lasts a few days to a couple weeks."
"What is most striking is that the child seems so well despite having a high fever."
Baby PP's case suits Roseola virus description. A high fever that dissapeared and  AFTER that rashes all over the back, abdomen, head and face. Rashes will only extend to the arms and legs in extreme cases. And she only want to be carried everywhere although she still somewhat smiling, laughing and curious about everything but must be on someone's lap. and she sleeps more than normal. It fits. Especially when most mommies forumers talk about baby fussiness and extra clingyness. Other than that, baby PP is quite a happy baby. Just dont let Mummy walk away from her. that is all.

 Busy playing after seeing the doctor that she did not realise something is amiss

"Mummy!!! I'M STUCK!"
Baby PP's being sick does include being stuck underneath the sofa during playtime
Fortunately, if it turnes out to be Roseola, Baby PP should recover in a few days without any intervention with no side effects. There is a chance of seizures but it should not cause any brain damage or anything to worry about. 

They only advise parents to "BE CALM, clear area of any objects that might hurt the child, turn child to the side so chocking on drool might occur and let the seizure run its course". Most important that i and the rest of the family to remember is....BE CALM...if it happens. Remember Mummylicious, be calm and carry on. 
"The good news: Once your child has had roseola, he'll probably have lifelong immunity to it."  BabyCenter

Rash still there albeit it looks less menacing. But it has truly spread all over her face! Awww

Roseola rash on baby face
Day 2: Rash spread all over Baby PP's face :(

Although Roseola rashes are not supposed to be itchy, we won't know right? Not like Baby PP can tell us if it itcy or not. And what if it was chicken pox? So in an effort to ease the possibly itchiness, we put a traditional Malay oitment on PP....which was....

BEDAK SEJUK! I dont know the translation in english, but it is basically white powder that is cooling to the skin. Old people and those that value traditonal beauty practice puts on bedak sejuk on the face to maintain clear skin.

And then we put them on ourselves in support of Baby PP! hehe 
and look at her staring at her Daddy's sudden "whiteness".

Whatever causing the rashes, it is still undiagnosed and we must patiently wait it out while looking forlornly at the sad, red face of Baby PP. 

Hopefully tomorrow, Monday, we can get something out from Baby PP's normal pead.
Update: 100% Roseola. Classic high fever, then 3 days later...small pimply rash all over. Completely harmless but heck scared the Fish out of me. "Rashes" (This link covers all the possible causes of baby rashes in the most descriptive way. Most useful)

Meningitis (Meningococcal meningitis/ Meningococcal septicaemia)

Useful knowledge from "Meningitis Health Notes"
Early symptoms of meningococcal septicaemia
One or more the following symptoms may indicate septicaemia:
* High temperature - above 39°C/102.2°F, which becomes difficult to control with fluids and infant paracetamol (suitable from three months)
* Severe or repeated vomiting
* Pain in joints and muscles
* Cold hands and feet
* Drowsiness, irritability and agitation
* Rapid breathing
* Blank and staring expressing
* A pin-prick red rash, that doesn't disappear under a glass tumbler test, and develops into purple bruises

Recognising meningitis in babies
Symptoms to look out for in children under 12 months are:
* Tense or bulging fontanelles
* Blotchy or pale skin
* Refuses feed
* A stiffening body with involuntary movements, or a floppy body
* He is fretful, with a shrill, moaning cry when handled


yunayuni said...

oh dear i think my baby is getting a chicken pox too. she is not having any fever but i noticed bumps on her body already :(

nice blog :) its good to find informative mommy bloggers around. should start sharing my experience too.

Unknown said...

Hi, I read your post with much interest... reason being my 5-month old daughter has the exact same situation (first, sudden fever; then flat rashes but extremely active) as baby PP...

I went through your posts after this post but found no updates.. So, is it roseola rash?

Appreciate your feedback! Thanks!!

Unknown said...

Hi, I read your post with much interest because my 5-month old baby has the exact symptoms (first sudden fever, then flat rashes but still very active) as baby PP.

So, is it really roseola rash??

Appreciate your feedback, thanks!!