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Exanthem
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Varicella findingsChoose anyNot in the note with these choices
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Counseling
Rashes like this are common with viral illnesses in children and fade on their own over several days without treatment. Recommended supportive care with tylenol or motrin as needed for comfort, with an emphasis on hydration. Return precautions given including a rash that does not fade when pressed, blisters or peeling, sores in the mouth or eyes, prolonged fever, unusual sleepiness, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.
CounselingNot in the note with these choices
Roseola is a common viral illness; the rash appears as the fever ends and fades on its own over a few days. Febrile seizures can happen with the high fevers of roseola. Recommended supportive care with tylenol or motrin as needed for comfort, with an emphasis on hydration. Return precautions given including a seizure, a rash that does not fade when pressed, unusual sleepiness, not drinking well, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.
CounselingNot in the note with these choices
Fifth disease is a mild viral illness; children are no longer contagious once the rash appears. The lacy rash can come and go with heat or sunlight for several weeks. Recommended supportive care with tylenol or motrin as needed for comfort or joint aches. Return precautions given including joint swelling, unusual paleness or tiredness, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.
CounselingNot in the note with these choices
Chickenpox is contagious until all the spots have crusted. Recommended supportive care with an emphasis on keeping nails short, frequent baths, and calamine or another anti-itch lotion; use tylenol for fever and avoid aspirin and motrin. Return precautions given including spots that become red, swollen, or very painful, fever returning after it went away, trouble breathing, unusual sleepiness, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.
What the sources cover
- Type: viral or roseola or fifth or varicella
- Varicella vesicles without superinfection
- Roseola: rash after fever resolves; febrile seizures
- Fifth: slapped cheek, lacy rash, not contagious once rash appears
- Pregnant contacts: low risk, serologic testing
- Varicella supportive care; no salicylates; avoid ibuprofen
- Antiviral for > 12 y, chronic skin/lung disease, steroids or salicylates, secondary household case; valacyclovir licensed 2-17
- Return when crusted or no new lesions in 24 h
- Rash without fever or behavior change: no exclusion