Antipyretic and anti-inflammatory drugs are most commonly used in the treatment of infantile rash and Kawasaki disease.

It is difficult to predict children’s acute rash, and nursing fever is the key.

Infant rash is a common disease in children. Most babies, Before the age of 1, The first fever was caused by this disease. In fact, this is also a viral infection. The reason why children’s rash is discussed after fever is that, Is because it usually manifests the symptom is high fever. This kind of disease even if you take the baby to the hospital, many times the doctor also can’t clearly give the diagnosis, can only make the diagnosis after the disease. Such as the baby’s hot relief rash, is burned for 3 ~ 4 days, the rash came out, the doctor according to these manifestations, can judge the baby suffering from the baby rash.

This kind of disease does not hurt the body so much, if the baby’s mental state is quite good after the fever is reduced with antipyretics, there is no need to worry too much. After the rash comes out, the baby will not have what symptoms, and the rash usually does not hurt or itch, so there is no need for special treatment for the rash.

I have a patient’s baby, For more than 5 months, she suffered from a baby rash. At first, she mistakenly thought that the baby had a fever and must not take antipyretic drugs for him. He insisted on cooling the baby physically, Even if the physical cooling cannot relieve the fever, the baby will not take medicine. When the baby burns to 39.8 ℃, The family’s psychological defense completely collapsed, Only then did I remember that I had Merrill Lynch at home. The baby is fine, Before convulsions and convulsions occurred, the family fed Merrill Lynch to the baby according to the estimated dose. As a result, after the baby finished eating for two hours, the body temperature quickly dropped to 35.2 ℃, and the body became cold. The baby’s mother was frightened at that time and immediately inquired about my microblog. At this moment, she only knew that the baby over 6 months old could eat Merrill Lynch! Also, even if the baby is old enough to eat Merrill Lynch, the dose should be given according to the baby’s weight instead of estimating the dose.

On the other hand, For the use of antipyretics, I have always stressed that, The preferred antipyretic should be acetaminophen, That is, tenolin, which is well known to parents, will only consider using Merrill Lynch, that is, ibuprofen, if the fever cannot be reduced after eating tenolin. Because in the instructions of ibuprofen, the order of action should be anti-inflammatory, analgesic and antipyretic. The primary pharmacological effect of ibuprofen is not to reduce fever, but to diminish inflammation and antipyretic.

Within 12 days of onset is the golden time to cure Kawasaki disease.

If you are not familiar with the name ibuprofen, you must have heard of its big brother aspirin. Aspirin and ibuprofen belong to the same anti-inflammatory and analgesic family and are the eldest son of this family.

In everyday life, Aspirin is a well-known and regular drug in the family. Many people have even summed up [headaches, fevers, A pack of aspirin]. However, The study found that, If the drug is given to children infected with the virus, It is easy to cause Reyer’s syndrome, a neuropsychiatric disease caused by aspirin. Patients show symptoms such as excessive fatigue, abnormal excitement, frequent vomiting, high body temperature and abnormal liver function, and the mortality rate can reach 30%. Therefore, all aspirin drug instructions will have the following sentence: [Children and adolescents under 16 years old should not take this product unless there are clear indications, such as Kawasaki disease.]

At present, the incidence of Kawasaki disease is getting higher and higher, It is necessary to popularize the disease here. To provide parents with some necessary knowledge. Kawasaki disease is also called mucosal lymph node syndrome. It is an acute, feverish and rash disease that often occurs in infants under 5 years old. Symptoms include persistent fever, rash, red lips, peeling of palms and soles of hands and feet, lymph node enlargement, The cause of the disease remains unknown. It is known as Kawasaki disease because it was first reported by Japanese doctor Fu Kawasaki. The first symptom of the disease is a fever accompanied by a rash, which is often misdiagnosed as a cold, measles or scarlet fever.

Judging whether you suffer from Kawasaki disease mainly depends on whether you have the following 6 manifestations

First, the fever lasts for more than 5 days, mostly at 38 ℃ ~ 40 ℃.

Cold usually fever 3 ~ 5 days will automatically reduce fever, more than 5 days of high fever must go to the hospital for a clear diagnosis. In addition, compared with the cold, Kawasaki disease children often lose appetite and mental health at the beginning of the onset, most of which are more serious at the beginning of the onset. However, children with colds often eat, drink and play at the beginning of the disease, and their mental state is good.

Second, bilateral white eyeballs, conjunctival congestion, but no ocular secretions.

Third, oral and pharyngeal mucosa is congested, lips are red and chapped, and strawberry-like tongue appears.

Fourth, cervical lymph node enlargement. This symptom is the least frequent of all major symptoms. The proportion of children under 2 years old can be as low as 50%. Many children under 2 years old do not have cervical lymph node enlargement.

Fifth, erythema multiforme is formed on the trunk, but there are no blisters or scabs. Erythema either fades gradually or forms larger spots, like maps.

Sixth, at the beginning of the onset of the palm and instep erythema, palm and instep red swelling, like chilblain hard swelling. The onset of the 10th to 15th days into the recovery period, began to appear fingers and toes membrane peeling.

The diagnosis of Kawasaki disease is relatively simple, only 5 out of 6 symptoms can be diagnosed. If only 4 out of 6 symptoms appear, but coronary artery aneurysm (or arterial enlargement) is confirmed by echocardiography or angiocardiography, Kawasaki disease can be diagnosed on the basis of excluding other diseases.

Two major mature treatments

It is gratifying for parents that Kawasaki disease is not a difficult and complicated disease, and the early treatment effect of Kawasaki disease is very good. Treatment within 12 days of the onset of the baby is considered early, and the vast majority can be cured.

First, aspirin. The early dose required will be relatively large. It is mainly aimed at inflammation, Continue to use small doses of aspirin at the later stage, It is mainly to prevent platelet aggregation and coronary artery thrombosis. This is well understood. In terms of pharmacological classification, Aspirin is a non-steroidal anti-inflammatory drug, It has anti-inflammatory effect, In addition, low-dose aspirin (75 ~ 100 mg) has anti-platelet aggregation effect, Therefore, it is now widely used as an antithrombotic drug. The Beijing Municipal Health Bureau has issued a news report, It is pointed out that thrombotic diseases are the leading causes of hospitalization and death in Beijing. Therefore, the Municipal Health Bureau has incorporated the work of “promoting aspirin to prevent thrombotic diseases” into the “Sunshine Great Wall Plan” to carry out professional training and guidance for community doctors so as to improve the utilization rate of aspirin for patients with thrombotic diseases, thus reducing the recurrence rate and improving the quality of life of patients.

Second, large doses of gamma globulin. 90% of children are sensitive to gamma globulin, Therefore, after using large doses of gamma globulin, Usually within 48 hours, Persistent high fever may subside, also can reduce the incidence of coronary artery disease. Children usually can be discharged from hospital in about a week, but coronary artery disease may lag behind, so within two months after cure, to continue to take small doses of aspirin, and regular cardiac color Doppler ultrasound or electrocardiogram review.

If early diagnosis and treatment can be carried out, cardiac complications caused by Kawasaki disease are rare. Parents should not be frightened by the terrible complications on the online encyclopedia. Usually, they should reserve more popular science knowledge on diseases. Early detection and treatment are the key when the disease is imminent.

Incidentally, if the baby is treated with gamma globulin, it is usually not recommended to vaccinate live vaccines (such as measles and varicella vaccines) within 11 months, because vaccination with live vaccines during this period may not produce antibodies, that is to say, it may be treated for nothing, and the vaccines cannot play their due protective role.

Author: Ji Lianmei

This article is taken from the book “Ji Lianmei Talk: Chinese Should Use Drugs This Way”, which is reprinted by the author’s authorized clove garden.