Tips on five infections faced by children

By Donya Betancourt

SANUR, Bali (JP): Thrush, canker sores, chelitis, herpangina and herpes are five of the many infections that our children may face in their lifetime. They are also infections that we as parents must learn to deal with and recognize so that we can help in the treatment and relieve ourselves of the stress that comes when our children are ill.

There is probably nothing more stressful than when our child is crying from hunger but cannot eat or drink because of pain in the mouth. If we examine the child's mouth and see white patches or ulcers, it is usually a sign of one of the previously stated infections.

The following is a more through description of each infection with a few helpful hints on their treatment.

1. Thrush (yeast infection) is not unusual in newborns or infants. Lesions appear as white patches covering all or part of oropharyngeal mucosa (mouth cavity). These patches are removable from the underlining tissue, which would be characteristically inflamed and hemorrhagic (bleeding). Discomfort associated with this infection may occasionally interfere with eating. The lesions are usually self-limited in healthy newborns but treatment with antifungal medication (prescribed by a doctor) applied four times a day directly to the lesions will hasten recovery and reduce the risk of spreading to other infants.

2. Canker sores (aphthous ulcer) are a distinct oral lesion prone to recurrence. The cause is unknown. The ulcers characteristically appear as either single or multiple lesions. Areas usually infected include the floor of the mouth (below the tongue) and less frequently on the palate or buccal mucosa (inner cheek). Typically the lesion is less than 0.5 centimeter in diameter with a depressed center and reddish periphery usually covered by a yellowish white discharge. Other symptoms include burning, itching or tenderness prior to the appearance of the ulcer. The lesions are painful and may make eating uncomfortable. Drinking cold liquids helps relieve the pain.

3. Cheilitis is drying of the lips followed by scaling and cracking. It is accompanied by a characteristic burning sensation and fever. It is usually caused by sensitivity to contact substances (toys and foods) or photosensitivity to sun rays. Applying ointment helps heal and prevent it from recurring.

4. Herpanginais an oral ulcer caused by enterovirus. Symptoms include mild fever of about 41 degrees Celsius (106 degrees Fahrenheit). Temperatures tend to be higher in younger children. Young patients may experience vomiting. The oral lesions are small 1-2 millimeter vesicles (small blisters) and ulcers. They are usually discrete, painless lesions on the soft palate, tonsil and posterior buccal (inner cheek) surface.

Symptoms are usually mild and without complication. The total course of the infection is around 3-6 days. Also, this virus can cause skin rashes which usually become vesicles on the hands and feet. It is called "hand-foot-mouth syndrome". There is no specific treatment for it.

5. Herpes simplex stomatitis is caused by herpes simplex virus type 1. It occurs in children, 2-4 years of age. Symptoms are fever, multiple vesicles scattered throughout the oral mucosa (oral cavity), tongue, gingiva (gum) and lips. There is medication for herpes simplex.

My hope is that with the above information, you would have peace of mind if and when your child is exposed to one of these common infections. Remember home care is good but please contact your doctor if you see no improvement in your child between 24 and 72 hours.

The writer is a pediatrician based in Sanur, Bali. If you have any questions, please feel free to write to her. Her e-mail address is drdonya@hotmail.com or features@thejakartapost.com