Rash Alert: What is the Glass Test? Can I panic now?!

When your kid have a rash on their skin, most times the parents will  first be going "Oh. no", then they start questioning themselves "Is this serious? Should I worry? Should I go to the doctor?" and then...they Google the symptoms....and then they cry or near tears because somehow the result is, something really really bad, probably will cause death. And we haven't even gone to the doctor yet!

Raise of hands how many parents go through this stage at one point or another?
*Mummylicious raises both hands.

"There are a myriad causes of rashes. Most of them are red and splotchy and no one can really tell you what caused it and then they go away, leaving no one much the wiser. There is however, one particular rash that it is really really important that you know how to look for." from Dr Orlena Kerek, Paediatritian, Snotty Nose.com

So how do you, as a parent, decide WHEN TO PANIC OR NOT TO PANIC?!!!! when we find rashes or anything that look like rashes/ bite marks on our precious children?

First, before you panic worry about the rash and frantically annoy your doctor or run to the ER, do the "glass test". All parents new or not-so-new parents should be aware of this test. Just for the sake of peace of mind, when the situation requires you to be alert, at least you know immediately what to do and annoy your doctor accordingly. 

"The glass test is a simple way of telling if a rash blanches. This means that when pressure is put on the skin, the rash fades. The glass test is useful, because it enables a parent to tell whether a rash is worryingly serious or not.

To perform the glass test

• Take an ordinary clear glass (or plastic) tumbler
• Place it on the skin next to the spots
• Roll it onto the spots, applying firm pressure. Note that the normal skin under the
  glass goes white as the blood is pushed out of the tiny surface blood vessels
• If the spots fade when the glass is rolled over them, the rash isn’t serious
• If a spot doesn’t fade, it is a non-blanching rash, and needs urgent medical attention"

from Babyworld.co.uk

 Here I did the "glass test" on PP's HSP Rash.
Not the first time I did this, but it was the first time the rash did not blanche. 

Rash Alert: Henoch-Schönlein Purpura Part 2

Continuation from Rash Alert: Henoch-Schönlein Purpura Part 1

After we came back from SDMC ER Outpatient, I started researching on "non-blanching rash", "non meningitis rash" basically, I went through all type of info on rashes and went through all type of photos. As if I can sleep before I can narrow down what the heck is this rash that does not blanche, causes MY daughter pain but not so serious that it can wait until the morning?!

Since the ER Doctor assured me it, he strongly does not believe it is bacterial meningitis due to the lack of fever and blood test results, it was a huge relief but not quite. Because he have no idea what else it could be. Not even a clue (maybe he had a clue but not saying).

Rash Alert: Henoch-Schönlein Purpura Part 1

I thought I had enough of SDMC's Emergency Room visits for this year (another story, another post). But of course, being a parent of two children....that obviously wasn't the case.

Ever since PP came back from last Sunday's Disney show...she have these substantial amount of bite marks on the bottom half of her legs. It looks like mosquito bites...or even mites. We assumed that she was bitten at the show...some infected chair at the auditorium ? even though her sister, Bambam, her Aunty Tiyah, and "Uncle" Kaiser have no bite marks whatsoever. But they were wearing pants....maybe they were not bitten because they wore pants? 

I was concern (of course) but the most that was done was to put some lotion to ease whatever itchiness and redness that might come from the bites. But here was the funny thing, I asked PP,

"Is it itchy?" "No" she answered

"Do you have a headache?" "No." (some can see where my brain was already going)

"Does your neck hurt?" "No." 

"Do you feel sick?" "No, I feel fine, mummy!"  Well.... Q&A session was clearly over. 

PP had no fever, I checked the soles of her feet and hands, they were clear, so I really didn't think too much about it. 

On Wednesday afternoon, the "bite marks" have diminished, no longer red. But come night time...she was in great pain! Her legs were hurting her, she said. Around the knee and ankle, she said. She can't walk because it would hurt her so much. And worse...the "bite marks" have turned into inflamed rashes. 

That was when I immediately asked for a clear glass - immediately did a "glass test" otherwise known as the "meningitis rash test" and saw that the rash did not blanche at all. Drop everything, and off we went to the hospital for medical attention. 

It is worth a note, The Daddy wanted to go to the 24 hours clinic nearby, but with a non-blanching rash, I am not taking my chance with clinics, I rather be at the hospital just in case things turn for the worse.  

(More on the rashes and what I did before I decided "TO PANIC OR NOT TO PANIC!" in Rash Alert: Henoch-Schönlein Purpura Part 2. Read HERE and HERE)

PP was in too much pain to walk, and you can see the rashes on legs from knee to ankle.

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. 

Thursday

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.

Friday

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. 

Saturday
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." Askamum.co.uk

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.

or 

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

Sunday

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.

Useful links

Birth.com.au "What is a normal temperature?"

AskDrSears.com "Rashes" (This link covers all the possible causes of baby rashes in the most descriptive way. Most useful)

AskDrSears.com "Roseola"

MedicineNet.com "Roseola"

KidsHealth "Roseola"

DrGreene "Roseola"

BabyCenter "Roseola"

Baby Medical Questions and Answers "Baby or Toddler Skin Rash?"

Meningitis (Meningococcal meningitis/ Meningococcal septicaemia)

Meningitis review

Useful knowledge from
AskAMum.co.uk "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