Peds Diseases

Disease 

Agent

Transmission

Symptoms

Treatment

Fifth’s Disease 

(Erythema Infectiosum) 

Parvovirus B19

Droplet, blood 

Contagious before rash develops 

Low grade fever, runny nose, headache

*red rash on cheeks “slapped cheeks”

*red and lacy rash on arms, legs, trunk, and buttocks 

Symptom management (usually hydration) 

*do not give medication for low grade fever

Roseola (Sixth Disease)

Herpes Virus

Droplet (via resp secretions or saliva) 

High fever, light pink non-itchy rash on trunk, neck, and proximal extremities (1-2 days)

High fever for 3-5 days, rash forms after fever

Complications: febrile seizure, viral meningitis 

Symptom management and hydration 

Tylenol can be given for high fever 

*never give motrin under 6 months 

Scarlet Fever 

Group A Beta Hemolytic streptococcus 

Can also come from simple strep 

Droplet and direct contact 

Fever, red and sore throat, flushed face, adenopathy, vomiting, strawberry tongue

*red, bumpy rash on chest for 5 days (looking like a scattered sunburn, feels like sandpaper) 

Complications: rheumatic fever, pneumonia, glomerulonephritis 

Antibiotics 

*amoxicillin is first line 

Hand, Foot, and Mouth Disease 

Coxsackie virus

Direct contact 

*very contagious 

Fever, sore and painful lesions in mouth, flat red spots or painful fluid-filled blisters on palms and soles 

Complications: viral meningitis, paralysis, nail loss

Hydration, cleaning (including handwashing), and management of pain 

Rotavirus

Fecal-oral contact

*very contagious 

Fever, nausea/vomiting, abdominal pain, diarrhea

Complications: dehydration, electrolyte imbalance

Dx: symptoms or stool sample

IV and PO fluids 

*do not give anti-diarrheal 

**oral immunization available (given at 2, 4, and 6 months) 

Diphtheria 

Corynebacterium diphtheria 

Droplet and contact

Extremely rare in US, still occurs outside US

Fever, anorexia, sore throat, stridor, swollen neck glands

Complications: airway obstruction, myocarditis, paralysis, respiratory failure, death

Dx: throat and lesions culture

Antitoxin and antibiotics 

*vaccine available

DTaP and Tdap

(diphtheria, tetanus, and pertussis) 

First dose 2 months, second 4 months, third 6 months, fourth 15-18 months, fifth 4-6 years

Chickenpox (Varicella)

Varicella-zoster virus

Airborne and direct contact 

*requires isolation 

Contagious 1 day before rash appears and until all vesicles have healed

Fever, malaise, headache, abdominal pain 

*clear, itchy, fluid-filled vesicles or blisters 

Papule to blister/vesicle to ulcer to scabbed 

Complications: skin infection, pneumonia, dehydration

Symptom management

*vaccine available 

Measles (Rubeola)

Paramyxovirus rubeola virus 

Airborne, droplet, and contact

*requires isolation 

Contagious days prior to being symptomatic 

*3 C’s: cough, coryza (runny, inflamed nose), conjunctivitis

Fever, anorexia, malaise

Red, blotchy maculopapular rash 3-5 days after symptoms start 

*Koplick spots (blue/white) on buccal mucosa 

Complications: pneumonia, encephalitis, death

Monitor respiratory status, supportive care, antibiotics for secondary infections 

*vaccine available MMR

Mumps (Parotitis)

Paramyxovirus 

Contact with respiratory secretions 

Fever, headache, malaise, loss of appetite, swollen face, tender jaw

*swollen parotid (salivary) glands 

Complications: *reproductive issues, meningitis, and deafness

Supportive treatment, antipyretics, bedrest 

*vaccine available 

MMR 

Rubella (German measles)

Rubella virus 

Droplet and direct contact 

requires isolation (*especially pregnant women)

Mild fever, headache, sore throat, malaise, cough, runny nose, conjunctivitis, 

*maculopapular rash starting on face then spreading to the rest of the body

Complications: hearing loss, vision changes, miscarriage in pregnant women, and fetal abnormalities

Supportive care 

*vaccine available 

MMR

Infectious Mononucleosis 

Epstein-Barr virus 

Bodily fluids, blood, organ transplant

Fever, extreme fatigue, sore throat, swollen lymph nodes, headache, body aches

*swollen liver or spleen

*non-specific red maculopapular rash  

Complications: dehydration and splenic rupture

Corticosteroids for airway swelling and symptomatic care 

**no contact sports (can cause splenic rupture) and no antibiotics (can cause rash)

Pertussis (Whooping cough) 

Bordetella pertussis

Droplet and direct contact with secretions 

*requires isolation 

Fever, runny nose, mild cough (more severe at night), coughing fits with ‘whooping” sound (due to attempt to catch breath)

Complications: pneumonia, apnea, weight loss, death

Dx: nasopharyngeal swab 

Antibiotics, respiratory monitoring, and supportive care 

*vaccine available 

Dtap and Tdap

Poliomyelitis 

Polio virus 

Fecal-oral and respiratory

Fever, sore throat, stiff neck, CNS symptoms, respiratory weakness, paralysis

Complications: paralysis, respiratory failure, death

Dx: throat, stool, or CSF cultures

No treatment, just symptom management

*vaccine available

IPV

Haemophilus Influenzae Type B (Hib)

h. influenzae bacteria

Droplet and direct contact 

*requires isolation

Fever, chills, cough, shortness of breath, sweating, chest pain, headache, muscle aches, fatigue, nausea, vomiting, diarrhea, and altered mental status 

Complications: bacteremia, sepsis, pneumonia, and death

epiglottitis andmeningitis 

Dx: blood or CSF culture

Antibiotics and supportive care

Prophylactic antibiotics for close contacts 

*vaccine available

Hib 

Otitis Media

Can be viral or bacterial 

Very different than swimmers ear

Ear pain, rhinitis, ear drainage, fever, decreased appetite

*infants and toddlers often display by pulling at ear and irritability

Complications: hearing loss, speech, and language deficits

Watch and wait to see if viral or bacterial 

Antibiotics, antipyretics, and ear drops 

*can get surgery for tympanostomy tubes which drains fluid for those who have recurrent ear infections

Impetigo

Streptococcus aureus and streptococcal pyogenes

Direct contact 

Low grade fever, runny nose, headache

*red macule or papule that crusts over into a blister or sore like itchy area

Complications: cellulitis, *scarlet fever, sepsis 

Topical antibiotics – mupirocin and bactroban

Clean sores with soap to prevent spreading 

Ringworm (Tinea Corporis)

fungus

Direct contact and contaminated surfaces

Red, raised papules in a scaly ring with central clearing 

Complication: skin infections

Antifungals 

Keep areas clean and dry, wash hands, instruct family to clean bedsheets 

Head Lice (Pediculosis Capitis) 

Pediculus humanus capitis 

Direct contact – close person to person 

Indirect contact – contact with contaminated surfaces

*lice do not jump or fly and only live 48 hours on one host 

Louse or eggs attaches to hair shaft close to the scalp 

Itchy scalp 

Pediculicides treatment for 1 week, intense combing, hot water laundering 

Education on treatment and how to stop the spread to others 

Scabies 

Human itch mite 

Skin to skin contact or indirect contact 

*highly contagious 

Extremely itchy red bumps, often in webbing of fingers and skin folds 

Eggs laid under the skin 

Complications: cellulitis

Scabicides 

Zczema 

Unknown cause, possible genetic disposition to environmental allergens 

Not contagious

Usually presents by age 5 

Lesions appear after scratching or rubbing (face, hands, elbow, knee creases, but can be anywhere

No treatment, symptomatic just control 

Topical corticosteroids 

Pinworms 

Enterobius vermicularis

Ingestion of eggs

Restlessness, trouble sleeping, intense anal and rectal itching – sometimes no symptoms 

Dx: ‘tape test’ 

OTC: pryantal pamoate

Rx: vermonx

*both OTC and prescription 

Teach risk of transfer and importance of hand hygiene 

Giardiasis (Giardia)

Protozoan 

Ingestion of fecal-oral water, soil, or food

Most common parasitic infection in US

Diarrhea, vomiting, greasy stools, abdominal pain, flatulence

Complications: dehydration, malnutrition, physical growth delay, developmental delay 

Dx: stool culture 

Antibiotic (flagyl) 

Hepatitis

*vaccines 

Hep A and Hep B: have a vaccine and are acute 

(Hep B can be chronic but usually not) 

Hep B: first vaccine at birth, second dose at 1-2 months, third dose at 6-18 months 

Hep C is chronic with no vaccine available