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    So Much Itching

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    Emily Eresuma
    The document describes a 4-year-old boy presenting with a rash. He had been coughing and congested 2 weeks prior and received vaccinations 6 days ago. 3 days ago his mother noticed itching on his buttocks and the next morning he was covered in red bumps with severe itching. His family members have also developed similar rashes. On examination, he has clusters of itchy red bumps on his back, buttocks, legs and arms. The document then discusses fleas as a possible cause, describing their symptoms and treatment options.

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    So Much Itching

    Uploaded by

    Emily Eresuma
    518 views14 pages
    The document describes a 4-year-old boy presenting with a rash. He had been coughing and congested 2 weeks prior and received vaccinations 6 days ago. 3 days ago his mother noticed itching on his buttocks and the next morning he was covered in red bumps with severe itching. His family members have also developed similar rashes. On examination, he has clusters of itchy red bumps on his back, buttocks, legs and arms. The document then discusses fleas as a possible cause, describing their symptoms and treatment options.

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    The document describes a 4-year-old boy presenting with a rash. He had been coughing and congested 2 weeks prior and received vaccinations 6 days ago. 3 days ago his mother noticed itching on his buttocks and the next morning he was covered in red bumps with severe itching. His family members have also developed similar rashes. On examination, he has clusters of itchy red bumps on his back, buttocks, legs and arms. The document then discusses fleas as a possible cause, describing their symptoms and treatment options.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    518 views14 pages

    So Much Itching

    Uploaded by

    Emily Eresuma
    The document describes a 4-year-old boy presenting with a rash. He had been coughing and congested 2 weeks prior and received vaccinations 6 days ago. 3 days ago his mother noticed itching on his buttocks and the next morning he was covered in red bumps with severe itching. His family members have also developed similar rashes. On examination, he has clusters of itchy red bumps on his back, buttocks, legs and arms. The document then discusses fleas as a possible cause, describing their symptoms and treatment options.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    of 14

    So Much Itching

    Morning Report 4/9/12 Adam Ware

    4 year old with rash


    CC: Rash History of Present Illnes:
    2 weeks ago had 10 days of cough, congestion, rhinorrhea. Received vaccinations 6 days ago
    MMR, DTAP, IPV, Varicella Local reaction with erythema, swelling, pus that lasted 2 days.

    3 days ago mother noticed pruritis of buttocks. Next morning he was covered in red bumps. Severe itching of bumps even while sleeping. 3 episodes of loose stools today. Calamine lotion over past day not helping.

    4 year old with rash


    Review of Systems:
    Positive: Subjective fever, pruritic rash, loose stool Negative: HA, congestion, rhinorrhea, cough, sore throat, vomiting,

    Past Medical History:


    34 week gestation hospitalized x 1 wk for respiratory distress, ROS. No recent hospitalization No surgeries

    4 year old with rash


    Family History:
    Multiple family members with URI sx 2 weeks ago. Brother, Mother, Grandmother all in ED today with similar rash.

    Social History:
    Lives with father, mother, 10 year old brother. Have stayed at grandmothers house for last 4 days. + smokers, 2 dogs, 1 cat, no travel.

    4 year old with rash


    Vital Signs:
    T: 36.8, P: 92, BP: 94/66, SPO2: 97%, Weight 19.3 kg (88%)

    Physical Exam:
    General: Running in room HEENT: NC/AT, PERRRLA, No cong/rhin, MMM, No oral lesions, No LAD, Skin: clusters of erythematous, blanching, macules with vesicular appearing center on back buttocks, legs, arms. Some with central Itching throughout the exam.

    Fleas
    Papules in non-follicular pattern Linear or in clusters (breakfast, lunch, dinner) Cause papular urticaria Can cause resp. symptoms. No anaphylaxis. Vector: Plague, Typhus, Bartonella

    Flea Treatment
    Symptomatic Treatment
    H1 blocker for pruritis (loratadine, cetirizine) Topical steroids

    Eliminate infestation.
    Flea bomb Pet Collars/Treatments

    Professional Insecticides

    Bedbugs

    Bedbugs
    Typically bite at night. Sx start morning after and up to 10 days later. Typical sites: Face, neck, hands, arms (exposed skin) Signs: fecal stains, blood spots, shed skins, carcasses, eggs and live bed bugs. Unclear if vector for disease but have been shown to carry Hep B/C, Chagas, HIV.

    Bedbugs

    Treatment
    Symptomatic Management:
    Topical steroids H1 blockers

    Environmental:
    Wash/dry clothes, Vacuum Super heating room: 50 C x 90 mins Card Method

    Professional Insecticides:
    Organophosphates

    Bedbugs vs Fleas
    Flea Trap Check your pet carefully. These include: fecal stains (aka blood spots), shed skins, carcasses, eggs and live bed bugs. Look for bugs in mattress, box spring & bed frame. Search all the seams, cracks & crevices where BBs may hide and/or place their fecal stains & eggs. Note that at 1 mm eggs are tiny and difficult to see.

    Flea Trap
    Soap Water Light

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