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Forum Name: Pediatric Topics

Question: Viral exanthem (rash)...how long can this go on?


 KYMomma0f2 - Mon Sep 22, 2008 8:39 pm

On Friday afternoon, September 12, I received a call from my son's daycare provider that he had a fever of 102.3. He is 10 months old. On Saturday morning, I took him to the clinic at our pediatrician's office and we saw his regular pediatrician. He was diagnosed with a viral throat infection. On Monday, I noticed some rash on his bottom and thought his eczema might be starting to flare up, so I put a little 1% hydro-cortisone cream on the rash and didn't think any more of it. I took him back to daycare on Tuesday and received a call from the daycare and was notified that he had a rash. So I went over and looked at it and sure enough he had broken out in a raised rash all over his trunk and back.

We had an appointment with his pediatric GI on Wednesday morning (he takes prevacid for acid reflux) and so I called her nurse to see if they could evaluate his rash and they said that they would do it at the appointment. His GI asked me a few questions like had he had a fever or virus in the last few days and I told her that he had. She said it looked like a viral exanthem and said that it would go away once the virus had run its course.

The next morning it had gotten worse, so I called the after hours nurse-line to see if he was contagious and after describing the rash, she told me that I should bring him in to the walk-in clinic at the pediatrician's office to make sure it's not scarletina. So he was seen by another doctor (not his regular pediatrician) and she confirmed the GI's diagnosis and said it was indeed a viral rash. She also noted 2 blisters on his throat. Again, the instructions were to ride it out.

But me being the worrisome mother, took him back on Saturday again because of the rash getting continually worse and a new symptom had appeared...gagging on his baby food. He saw his regular pediatrician again and he said again that it was viral and that it could last another week. He said that his throat did look much better than it did a week ago and that the two blisters were still there, but they could last several more days. He didn't seem worried at all.

This rash is BAD. And while he's not gagging on vegetables anymore....He cries on fruit. Maybe the acid is burning the rash or the blisters inside his throat???? Who knows...But I'm starting to go crazy here...The rash has also spread upward to his face and around his eyes. It's red and raised all over his body down to the tops of his feet and arms....his bottom is bright red and looks worse because of the heat and moisture in his diaper....but he doesn't seem to itch. He's just not his usual laid back self. I'm wondering how much longer can this go on? I didn't think a virus could last this long...and the blisters in his throat have been over a week...and the rash seems to be not getting any better at this point and it's been 7 days. How long can these things last?

I would also like to know what distinguishes a viral rash from a strep rash like scarletina...and how can you tell by looking at a throat that it's a virus rather than strep throat (although I know strep is RARE in children under 3)....A swab has never been ordered for him, so I'm wondering what makes a doctor so sure...

I love his pediatrician....he's been wonderful to us. I guess I would just like these questions answered because I always think of other things after we have left the office...go figure.

I haven't changed or added anything to his diet, nor have I changed detergents...The daycare has not done anything different either...

Thanks for taking the time to answer and read this long post....
 Dr. Chan Lowe - Sat Jan 17, 2009 2:28 pm

User avatar Hello KYMommaOf2,

First, you are not the first, nor will you be the last parent to continue to worry after the doctor has said something is OK. If you didn't do this at least a little you wouldn't be a parent.

Regarding your son's rash, I'll answer your second question first. Scarlet fever (or scarletina) is a rash caused by an infection with a bacteria called streptococcus. The rash is often very light and has a sandpaper like feel to it. Often times you can feel the rash more than you can see it. What you are describing does not sound to me like a scarlet fever rash.

Viral exanthems are quite variable in their presentation. Some can last only for a few days (or even hours). Others can persist for several weeks. They may or may not be itchy. They can look quite disturbing at times. Generally, as long as as the child is otherwise OK, we just wait them out. If it is persisting for more than a few weeks it is probably a good idea to have it reevaluated to be sure everything is still OK.

Best wishes.

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