- Risk Factors
Rocky Mountain spotted fever is a bacterial infection transmitted by a tick. Without prompt treatment, Rocky Mountain spotted fever can cause serious damage to internal organs, such as your kidneys and heart.Although it was first identified in the Rocky Mountains, Rocky Mountain spotted fever is most commonly found in the southeastern part of the United States. It also occurs in parts of Canada, Mexico, Central America and South America.Early signs and symptoms of Rocky Mountain spotted fever...
Although many people become ill within the first week after infection, signs and symptoms may not appear for up to 14 days. Initial signs and symptoms of Rocky Mountain spotted fever often are nonspecific and can mimic those of other illnesses: 1. High fever 2. Chills 3. Severe headache 4. Muscle aches 5. Nausea and vomiting 6. Confusion or other neurological changes
Rocky Mountain spotted fever is caused by infection with the organism Rickettsia rickettsii. Ticks carrying R. rickettsii are the most common source of infection.If an infected tick attaches itself to your skin and feeds on your blood for six to 10 hours, you may pick up the infection. But you may never see the tick on you.Rocky Mountain spotted fever primarily occurs when ticks are most active and during warm weather when people tend to spend more time outdoors. Rocky Mountain spotted fever...
Factors that may increase your risk of contracting Rocky Mountain spotted fever include: 1. Living in an area where the disease is common 2. The time of year — infections are more common in the spring and early summer 3. How much time you spend in grassy or wooded areas 4. Whether you have a dog or spend time with dogsIf an infected tick attaches to your skin, you can contract Rocky Mountain spotted fever when you remove it, as fluid from the tick can enter your body through an opening such a...
Rocky Mountain spotted fever damages the lining of your smallest blood vessels, causing the vessels to leak or form clots. This may cause: 1. Inflammation of the brain (encephalitis). In addition to severe headaches, Rocky Mountain spotted fever can cause inflammation of the brain, which can cause confusion, seizures and delirium. 2. Inflammation of the heart or lungs. Rocky Mountain spotted fever can cause inflammation in areas of the heart and lungs. This can lead to heart failure or lung f...
You can decrease your chances of contracting Rocky Mountain spotted fever by taking some simple precautions: 1. Wear long pants and sleeves. When walking in wooded or grassy areas, wear shoes, long pants tucked into socks and long-sleeved shirts. Try to stick to trails and avoid walking through low bushes and long grass. 2. Use insect repellents. Products containing DEET (Off! Deep Woods, Repel) often repel ticks. Be sure to follow the instructions on the label. Clothing that has permethrin i...
Feb 18, 2020 · When young children have a fever, if can be difficult for parents to work out why. In most cases, the fever is due to a non-serious viral infection. Many viral infections that affect young children cause a fever of up to 48 hours in duration before other symptoms develop. A small number of common viruses cause fevers that last longer than this.
- Dr Sarah Jarvis MBE
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A normal temperature in babies and children is about 36.4C, but this can vary slightly from child to child. A high temperature is 38C or more. A high temperature is the body's natural response to fighting infections like coughs and colds. Many things can cause a high temperature in children, from ...
Aug 28, 2018 · Rocky Mountain spotted fever (RMSF) is a bacterial infection spread by a bite from an infected tick. It causes vomiting, a sudden high fever around 102 or 103°F, headache, abdominal pain, rash, and...
- Jacquelyn Cafasso
Acetaminophen (Children's Tylenol, Tempra) and ibuprofen (Children's Advil, Children's Motrin) are used to reduce fever. Follow the dosage and frequency instructions printed on the label. Remember to continue to give the medication over at least 24 hours or the fever will usually return.
- Signs and symptoms
Bronchiolitis is a common lower respiratory tract infection in infants and young children, and respiratory syncytial virus (RSV) is the most common cause of this infection. RSV is transmitted through contact with respiratory droplets either directly from an infected person or self-inoculation by contaminated secretions on surfaces. Patients with RSV bronchiolitis usually present with two to four days of upper respiratory tract symptoms such as fever, rhinorrhea, and congestion, followed by lower respiratory tract symptoms such as increasing cough, wheezing, and increased respiratory effort. In 2014, the American Academy of Pediatrics updated its clinical practice guideline for diagnosis and management of RSV bronchiolitis to minimize unnecessary diagnostic testing and interventions. Bronchiolitis remains a clinical diagnosis, and diagnostic testing is not routinely recommended. Treatment of RSV infection is mainly supportive, and modalities such as bronchodilators, epinephrine, corticosteroids, hypertonic saline, and antibiotics are generally not useful. Evidence supports using supplemental oxygen to maintain adequate oxygen saturation; however, continuous pulse oximetry is no longer required. The other mainstay of therapy is intravenous or nasogastric administration of fluids for infants who cannot maintain their hydration status with oral fluid intake. Educating parents on reducing the risk of infection is one of the most important things a physician can do to help prevent RSV infection, especially early in life. Children at risk of severe lower respiratory tract infection should receive immunoprophylaxis with palivizumab, a humanized monoclonal antibody, in up to five monthly doses. Prophylaxis guidelines are restricted to infants born before 29 weeks' gestation, infants with chronic lung disease of prematurity, and infants and children with hemodynamically significant heart disease.
There are seasonal differences in the incidence of RSV infection in the United States, although the highest incidence occurs from December to March.6 Nearly all children have been infected with RSV at least once by two years of age. Most children have a self-limited course that responds to supportive home care; however, approximately 2% to 3% of infants younger than 12 months are hospitalized with an RSV infection each year in the United States.7 It is estimated that more than 57,500 hospitalizations and 2.1 million outpatient visits are associated with RSV infections each year in U.S. children younger than five years.6 The strongest predictor of hospitalization is chronologic age, with the highest rate of hospitalization occurring in the first 90 days of life.8
Patients with RSV bronchiolitis usually present with two to four days of upper respiratory tract symptoms, such as fever, rhinorrhea, and congestion, followed by lower respiratory tract symptoms. Increasing cough is usually the first sign of lower respiratory tract involvement; later symptoms include tachypnea, dyspnea, increased respiratory effort, and difficulty feeding.1,2 Patients with a normal respiratory rate are at low risk of significant viral or bacterial lower respiratory tract infection or pneumonia, although the presence of tachypnea cannot be used to distinguish between viral and bacterial infections.4 Physical examination findings usually include auscultation of wheezing and crackles, and may include evidence of increased respiratory effort such as grunting, nasal flaring, or retractions.1,2 In infants presenting with lower respiratory tract symptoms, the history and physical examination findings help distinguish viral bronchiolitis from other causes and can help estimate disease severity.4 Common predictors of the need for hospital admission are shown in Table 1.12,13 Another study found that age of two months or more, no history of intubation, a history of eczema, lower respiratory rate, no or only mild retractions, initial oxygen saturation of at least 94%, and adequate oral intake predicted safe discharge.13 Apnea may be an early manifestation of RSV bronchiolitis and other viral etiologies, and is more common in infants two to eight weeks of age and in those with birth weight less than 5 lb, 1 oz (2,300 g).14 When assessing disease severity, an important factor is the effect of the patient's symptoms on mental status, feeding, and hydration.4
RSV bronchiolitis has a more severe clinical course than non-RSV bronchiolitis, including a longer hospital stay.15 However, virologic testing on an individual basis is insufficient to predict outcomes and does not affect management decisions.15 Therefore, RSV testing should not be routinely performed except in hospitalized infants who are receiving monthly prophylaxis (so that further prophylaxis can be discontinued because of the low risk of having a second RSV infection in the same year).4,15 Chest radiography findings in patients with bronchiolitis include peribronchial markings, hyperinflation, and atelectasis. However, chest radiography should not be performed routinely because it does not improve clinical outcomes and is associated with increased antibiotic use.15,16 Pulse oximetry is often used to identify children with hypoxemia, although it has been implicated in increased rates of hospital admission with no other clinical outcome data supporting its use.4,17,18 Use of a bronchiolitis guideline in the emergency department may decrease chest radiography, RSV testing, and albuterol use, as well as length of hospital stay and total cost.19
The mainstay of therapy for acute RSV bronchiolitis in infants and children is supportive care (Table 2). Oxygen saturation of 90% or more is sufficient for children with bronchiolitis.4 No data support the use of supplemental oxygen to maintain higher oxygen saturation, and doing so only prolongs hospitalization because of an assumed need for oxygen.20 Furthermore, any transient desaturation is considered normal in otherwise healthy infants.21 A small study showed that high-flow nasal cannula oxygen may be a viable option for infants with persistent hypoxemia (oxygen saturation less than 90% with fraction of inspired oxygen of 0.4, or respiratory rate of 60 breaths or more per minute).22 Other treatments with no clear clinical benefit include chest physiotherapy and excessive nasal suction of secretions.39,40 Passive slow expiration technique may provide some short-term relief, but neither vibration nor percussion is beneficial. Although nasal suctioning provides relief of symptoms, excessive or deep nasal suctioning is associated with longer hospitalization. On the other hand, failure to perform routine external suctioning every four hours is also associated with increased length of stay.40
Pulse oximetry alone is an unreliable measure of hypoxemia and respiratory distress, and continuous use is optional in infants and children with bronchiolitis.23 Continuous pulse oximetry lends to negative sleep effects on patients' families and alarm fatigue for families and staff. Its use is implicated in increased hospitalization rates without significant change in mortality.24
Bronchodilators should not be administered to infants and children with bronchiolitis. Despite short-term improvement in clinical symptom scores, they have no effect on the need for hospitalization, oxygen saturation, length of hospitalization, or disease resolution.24,27 A 2014 Cochrane review of 30 randomized controlled trials found that infants with bronchiolitis who received bronchodilators did not have significant improvements in oxygen saturation, rate of hospitalization, or duration of hospitalization.24 In the outpatient setting, a short-term improvement was seen in clinical symptom scores using different scoring systems, some of which were partially validated. This analysis also included studies of children with recurrent wheezing, such as those with asthma, who are known to respond to bronchodilators.24 Ultimately, the adverse effects of bronchodilators, including high cost, tachycardia, and tremors, likely outweigh the possible short-term benefits.24 Epinephrine should not be administered to children with bronchiolitis in the inpatient setting.28,29 Outpatient epinephrine use is controversial. A 2011 Cochrane review of first-time wheezing among infants showed a statistically significant reduction in admission rates in patients who received nebulized epinephrine compared with placebo. However, this reduction was found on only the initial day of presentation, and there was no statistically significant reduction in the overall admission rate, likely because of the relatively short-acting effects of epinephrine.30 Nebulized hypertonic saline (3% or 7%) also should not be administered to infants with bronchiolitis in the emergency department or when the hospital stay is less than three days.4,31,32 Although it decreases the length of stay in patients hospitalized for more than three days, this benefit may not be applicable to patient populations in the United States, where the average length of stay is less than three days.31 Although the mechanism of action of hypertonic saline supports its benefit in chronic lung disease, it should not be administered to infants with bronchiolitis in the emergency department; however, it may be beneficial if administered in the inpatient setting.4 Antibiotics should not be administered to infants and children with bronchiolitis and should be reserved for those with concomitant bacterial infection.4,35,36 Overall, there is a very low rate of bacteremia in patients diagnosed with bronchiolitis.35 Antibiotic therapy during acute bronchiolitis or in the postacute phase (after 14 days) does not reduce length of hospitalization or improve clinical outcomes.37 Antibiotic therapy may be administered in some subpopulations, including children with bronchiolitis who require intubation and mechanical ventilation for respiratory failure, because their risk of bacterial pneumonia is higher.38
Educating parents on reducing the risk of infection is one of the most important things a physician can do to help prevent RSV infection, especially early in life. RSV is highly contagious and is transmitted through direct contact with respiratory droplets. Secretions can remain infectious for more than six hours on hard surfaces such as tabletops, cribs, and toys.2,4 Strict hand hygiene must be adhered to, including washing hands before and after contact with a patient infected with RSV, after contact with surfaces near the patient, and after removal of gloves. Alcohol-based hand solutions are recommended for health care professionals; soap and water should be used if these are not available.4,41 In addition to frequent hand washing by caregivers, avoidance of large crowds and day care settings can also decrease the risk of infection.42,43 The morbidity of respiratory infections can be lowered by encouraging exclusive breastfeeding for at least six months and preventing exposure to secondhand smoke.4,44,45 Infants at risk of severe lower respiratory tract infection should receive immunoprophylaxis with palivizumab (Synagis). Five doses provide six months of coverage, which is sufficient protection for the RSV season. The initial recommendations for palivizumab in 1998 and again in 2003 were based on the results of two randomized, double-blind, placebo-controlled trials that reported a reduction in RSV hospitalization among high-risk infants who received palivizumab.42 A prospective, population-based surveillance study in 2005 found that the rate of RSV hospitalization was increased only among infants born before 30 weeks' gestation.8 In 2014, palivizumab prophylaxis guidelines were updated, with the goal of restricting its use to infants and children at greatest risk (Table 3).42
Jan 17, 2020 · As ironic as it sounds, cedar fever does not actually produce a fever. In fact, cedar fever is a seasonal allergy brought on by an allergic reaction to the pollen from mountain cedar trees. Mountain cedar grows naturally and is the most allergenic tree in Central Texas. Cedar Fever Symptoms An allergic reaction to mountain cedar causes many symptoms that aggravate those affected. A few of ...
Valley Fever Risk Factors . Anyone can contract Valley Fever. Once infected, however, certain groups seem to have more instances of it spreading to other parts of their bodies; as far as gender is concerned, men are more likely than women, and, when considering race, African Americans and Filipinos are more likely to have the disease spread.
About Fever Normal body temperature varies between people. Even in the same person, normal body temperature varies depending on age, activity, and time of day. The average normal body temperature is 98.6°F (37°C). Body temperature above 100°F is usually classified as fever.