Causes: The disease is common in children ages 3 months to 4 years, and most common in those ages 6 months to 1 year. It is caused by a virus called human herpesvirus 6 (HHV-6), although similar syndromes are possible with other viruses.

Roseola occurs throughout the year. The time between becoming infected and the beginning of symptoms (incubation period) is 5 to 15 days. A fever lasting 3 (sometimes up to 7) days generally comes before the rash appears. The fever may be as high as 105 degrees Fahrenheit.

Roseola begins with a high fever that generally responds well to acetaminophen (Tylenol). Between the 2nd and 4th day of illness, the fever falls dramatically, and a rash appears (often as the fever falls) on the trunk and spreads to the limbs, neck, and face. The rash lasts from a few hours to 2 days.

Symptoms: Irritability; Quick onset of high fever; Rash erupts on days 4 to 5 of the illness (the fever has usually gone away or is dropping by the time the rash appears)

Exams and Tests: Physical exam of rash; Swollen lymph nodes on the back of the scalp (occipital nodes)

Treatment: There is no specific treatment. The disease usually gets better without complications. Take steps to control a fever with acetaminophen (Tylenol) and cool sponge baths. If convulsions occur, call your health care provider, or go to the closest emergency room.

Outlook (Prognosis)

Most children with roseola fully recover.

Possible Complications: Aseptic meningitis (rare); Encephalitis (rare);Febrile seizure

When to Contact a Medical Professional

Call your health care provider if your child's fever does not go down with acetaminophen (Tylenol) or ibuprofen (Advil) and a warm bath, or if the child continues to appear very sick, or act irritable or lethargic.

Go to the emergency room or call the local emergency number (such as 911) if your child has convulsions.

Prevention: The viruses that cause roseola are spread either through fecal-oral contact or via airborne droplets. Careful handwashing can help prevent the spread of these

Toxic Synovitis

July 1, 2016 Kevin Patrick

Toxic synovitis, also known as transient synovitis, is the most common cause of hip pain in children. It is caused by a viral infection that sometimes (but not always) settles in the hip joint. The virus causes swelling at the hip joint, which makes walking painful. Usually just one hip is affected. But later on, the virus can pass to the other hip.

Toxic synovitis is more common in boys and affects preschool to early school-aged kids, but younger kids also can develop it.

Sometimes toxic synovitis is confused with septic arthritis, or infectious arthritis, a more serious condition caused by a bacterial infection that invades the joints and can cause long-term joint damage. Your doctor can rule out septic arthritis or other conditions through a physical exam and diagnostic tests.

Symptoms

When kids have toxic synovitis, the pain may come and go or shift from one hip to the other. Here are more signs to look for:
•recent history of a viral infection, such as a cold or stomach virus
•low-grade fever (up to 101°F)
•limping with toes turned outward, the knee bent or straightened
•walking on tiptoe
•hip discomfort that occurs after a long period of resting the joint (such as sitting in a car, at a desk, or watching TV)
•knee or thigh pain with no hip pain
•in younger children, crying
•in some cases, a refusal to walk

In babies, the most common signs of toxic synovitis are abnormal crawling and crying, and they may cry in situations where their hip joints are being moved, such as diaper changing.
Diagnosis

The first thing a doctor will do is examine your child, checking to see what kind of movement is painful by moving the knee, the hip, and other joints. This is to confirm that limping is caused by hip pain.

Next, the doctor may order an ultrasound of the hip, an imaging test that will determine whether there is fluid in the hip joint. Fluid indicates swelling and inflammation in the tissues. The doctor also might do a blood test to look for inflammatory markers, other signs that show the extent of swelling in the hip joint.

In cases where the inflammatory markers or fever seem high and the doctor is having difficulty ruling out septic arthritis, your child may need to have fluid removed for a culture (lab test). The doctor also may perform blood tests to rule out Lyme disease, as well as X-rays for Legg-Calve-Perthes disease, a progressive condition that causes a loss of bone tissue.

Treatment

Treatment for toxic synovitis usually includes anti-inflammatory drugs such as naproxyn or ibuprofen. Your child will take these medications for up to 4 weeks until the inflammation goes away. The doctor may also prescribe medicine for pain, such as acetaminophen.

Resting the hip joint is important and it's best if your child avoids putting weight on the hip while recovering. Usually within a day or two of taking the anti-inflammatory medicine, kids are able to walk again comfortably. However, participation in activities like gym class or contact sports may have to wait until your child fully recovers.

Egg Allergy and Vaccines

July 1, 2016 Kevin Patrick

Some vaccines contain egg protein. The recommendations of the American Academy of Pediatrics (AAP) acknowledge that the MMR vaccine (measles-mumps-rubella) can be safely administered to all patients with egg allergy. These recommendations have been based, in part, on scientific evidence that supports the routine use of one-dose administration of the MMR vaccine to patients with an egg allergy. This includes those patients with a history of severe, generalized anaphylactic reactions to egg.

Influenza vaccines usually contain a small amount of egg protein. According to the American Academy of Allergy, Asthma & Immunology (AAAAI): "Studies show that flu vaccines can be safely administered to egg allergic individuals, wither in the primary care provider's office or allergist's office depending on the severity of the allergic reaction to eating eggs." If you or your child is allergic to eggs, speak to your doctor before receiving a flu shot.

Introducing Solid Foods

July 1, 2016 Kevin Patrick

For a long while, I did not like the idea of making a chart for introducing solid foods to infants. I just wanted to start with a general guideline for introducing solids, because I believe every baby is different and every family has their own different preferences. Rigid rules for feeding is not my thing! Family can be creative as long as you following the general rules.

In general, babies can start eating solids from 4-6 months of age, but some babies start early if they develop normal, advanced or baby shows interest. The most common first solid food is cereal, rice oatmeal, or barley; which ever the family prefers. Most families add cereal into their infant's bottle 2-3 times per day, or mix a small amount of formula into pasty mixture for spoon feeding 2x per day.

Once the baby is swallowing well, family can start with vegetables, stage I vegetables: carrots, peas, green beans, squash, potatoes, and sweet potatoes. With every new item, family should give three to four days to make sure their infant does not have any allergies, intolerance, symptoms, etc. (rash, gassy, vomit, loose stool, or simply refusing to eat).

I personally like to start fruits after vegetables. First stage fruits are apples, bananas, peaches, and pears. General rules to rule out allergies apply here as well.

Grounded meat like chicken, turkey, or beef starts after 6 months of age depending on the readiness of the baby and how well the baby is doing with vegetables and fruits. Usually, just add a few teaspoons of grounded meat into vegetables to make a mixture for feeding.

Most babies advance to stage II or increase coarseness of the texture around 8-9 months, some babies can even handle table foods, of course with caution and direct supervision by an adult. Finger foods are welcome for this age as well, since the feeding activities are great fine muscle exercise for the age.

Which food items to avoid is always an interesting topic. Every culture can be quite different. Medically, egg, nuts, seafood, and honey should be avoided during the first year. If your family likes to start fish, I recommend tilapia and/or salmon to start. However, you will want to limit the amount of fish since mercury is present in seafood.