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Diarrhea and strep throat: Vomiting and Diarrhea | Blue Cross NC

Vomiting and Diarrhea | Blue Cross NC

What is it?

Like fever, vomiting and diarrhea are not illness themselves, but are common symptoms of many other common illnesses of childhood. The most common cause of vomiting and diarrhea in children is a stomach or intestinal infection, typically caused by a virus, but occasionally can be caused by a bacteria or parasite. These viruses are contagious, so typically other children or family members will have it as well. Other illnesses that can cause vomiting and diarrhea include:

  • Strep throat infection
  • Urinary tract infection
  • Respiratory or sinus infection
  • Meningitis
  • Ear infection
  • Appendicitis
  • Reyes syndrome
  • Milk or food allergy
  • Side effects from oral medications (usually antibiotics)

What are the symptoms?

The following signs indicate a need to contact the child’s physician:

  • Stomach contents or diarrhea with blood or bile in them. Bile is a bright yellow green color.
  • Severe abdominal pain
  • Strenuous, repeated vomiting
  • Swollen abdomen
  • Lethargy or severe irritability
  • Convulsions or seizures
  • Inability to drink adequate amounts of fluid
  • Vomiting following a head injury
  • Moderate to severe dehydration (see below) or continued vomiting or watery diarrhea with a mild diarrhea
Condition Symptom
Mild dehydration
  • Restless / fussy
  • Acts hungry or thirsty all the time
  • Urinates less frequently than unusual, requires fewer diaper changes. Urine will have a strong odor and will be darker yellow than normal.
Moderate dehydration
  • Has decreased interest in play
  • Eyes are sunken with few tears
  • Child’s mouth is dry with little or no saliva
  • Has not urinated in 8 hours or has urinated fewer than
  • 3 times in 24 hours
Severe dehydration 
Severe dehydration is a medical emergency. Call 911 or emergency services immediately
  • Lack in interest in playing and extreme sleepiness (the child may be so sleepy that he or she is difficult to wake up)
  • Eyes are very sunken and without tears
  • Mouth and tongue are very dry
  • Drinks poorly/unable to drink
  • No urination in 12 hours

How can I treat vomiting and diarrhea?

It is important to prevent dehydration. Make sure your child drinks plenty of fluids when they are sick (even though they may not be thirsty) such as an oral rehydration solution. Nursing mothers should continue to breastfeed. If your child is suffering from diarrhea, avoid sugar-based beverages such as sports drinks, soda, or juices. The sugar can draw water into the intestines and away from the rest of the body, making the diarrhea worse and increasing the risk of dehydration. Additionally, these beverages may not contain electrolytes that need to be replenished.

Oral-rehydration suggested scheduled:

Age Amount Timing
Less than 2 ½ cup Every hour
Older than 2 Up to 1 cup Every hour
If vomiting – even if your child vomits after drinking the fluid part if it will stay down 1-2 teaspoons Every 1-2 minutes. Once the child is doing better increase to bigger sips spread 5 minutes apart

Once nausea and vomiting have subsided you can resume a normal diet such as breastfeeding, formula (½ strength for 2 days), or solid foods (avoid high fat foods)

Important additional information

  • When a toddler vomits, it is important to make sure he or she has not swallowed medications, household liquids, or other poisons. Look around the house for empty containers and spills. There may be pills in your child’s vomit or the vomit may have an unusual appearance, color, or odor.
  • Do not give your child anti-diarrheal medications unless your physician tells you too.

The following are examples of over-the-counter (OTC) products that can be used to treat the symptoms of vomiting and diarrhea:

Symptom relief Helpful medications Active ingredients* to look for in generic and name brand OTC products
Dehydration Oral rehydration products** Oral electrolyte solution 
Example: Pedialyte®

* Active ingredients: ingredients in a medication that produce a therapeutic response

** Oral rehydration solutions are helpful medications for keeping your child hydrated however, they will not stop diarrhea

Note: This information is intended to provide readers with health information. The information provided is not a substitute for consultation with a healthcare provider. Brand names included on this Web page are provided for examples only. Their inclusion does not mean that they are endorsed by Blue Cross and Blue Shield of North Carolina.

Abdominal Pain in Children – HealthyChildren.org

Constipation often is blamed for abdominal pain, and while it’s rarely a problem in younger infants, it’s a common cause of pain in older children, especially in the lower part of the abdomen. When a child’s diet lacks plenty of fluids, fresh fruits and vegetables, and fiber rich in whole grains, bowel problems are more likely to occur. For more information, talk to your pediatrician.

Urinary tract infections (UTI) are much more common in one- to five-year-old girls than in younger children. UTIs produce discomfort in the abdomen and the bladder area, as well as some pain and burning when urinating. These children also may urinate more frequently and possibly wet the bed. However, the infection usually does not produce a fever. If your child complains of these symptoms, take her to the pediatrician, who will examine her and check her urine. If an infection is present, an antibiotic will be prescribed, which will eliminate both the infection and the abdominal pain.

Strep throat is a throat infection caused by bacteria called streptococci. It occurs frequently in children over three years of age. The symptoms and signs include a sore throat, fever, and abdominal pain. There may be some vomiting and headache as well. Your pediatrician will want to examine your child and swab her throat to check for strep bacteria. If the results are positive for strep, your child will need to be treated with an antibiotic.

Appendicitis is very rare in children under age three and uncommon under the age of five. When it does occur, the first sign is often a complaint of constant stomachache in the center of the abdomen, and later the pain moves down and over to the right side.

Lead poisoning most often occurs in toddlers living in an older house where lead-based paint has been used. Children in this age group may eat small chips of paint off the walls and woodwork. The lead is then stored in their bodies and can create many serious health problems. Parents also should be aware of toys or other products with unacceptable lead content. Symptoms of lead poisoning include not only abdominal pain, but also constipation, irritability (the child is fussy, crying, difficult to satisfy), lethargy (she is sleepy, doesn’t want to play, has a poor appetite), and convulsions. If your child is exposed to lead paint, has eaten paint chips or been exposed to toys with cracking, peeling, or chipping paint and has any of the above symptoms, call your pediatrician. She can order a blood test for lead and advise you as to what else needs to be done.

Milk allergy is a reaction to the protein in milk, and can produce cramping abdominal pain, often accompanied by vomiting, diarrhea, and skin rash.

Emotional upset in school-age children sometimes causes recurrent abdominal pain that has no other obvious cause. Although this pain rarely occurs before age five, it can happen to a younger child who is under unusual stress. The first clue is pain that tends to come and go over a period of more than a week, often associated with activity that is stressful or unpleasant. In addition, there are no other associated findings or complaints (fever, vomiting, diarrhea, coughing, lethargy or weakness, urinary tract symptoms, sore throat, or flulike symptoms). There also may be a family history of this type of illness. Finally, your child probably will act either quieter or noisier than usual and have trouble expressing her thoughts or feelings. If this type of behavior occurs with your child, find out if there’s something troubling her at home or school or with siblings, relatives, or friends. Has she recently lost a close friend or a pet? Has there been a death of a family member, or the divorce or separation of her parents?

Your pediatrician can suggest ways to help your child talk about her troubles. For example, he may advise you to use toys or games to help the child act out her problems. If you need additional assistance, the pediatrician may refer you to a child therapist, psychologist, or psychiatrist.

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Is it Strep Throat or the Flu?

Your child’s throat is sore, has a headache and a fever.

Is it strep or the flu? Maybe, both?

Strep and flu are two very different things, although they may have similar symptoms at times.

First, let’s distinguish between the two.

The flu is a viral infection that impacts the nose, throat and lungs. A flu, or cold, can make the throat sore and scratchy

Strep is a bacterial infection. Strep causes the throat to be very sore and it becomes very painful to swallow and they typically don’t eat, or only eat very soft things. With a cold or flu, children usually eat fine or if not the reason is appetite not pain with swallowing.

They both can cause a fever, sore throat, chills, muscle aches and even nausea.

So how do you tell the difference?

Even for a pediatrician, it’s difficult to distinguish strep from the flu by a quick look inside a child’s throat. Studies have been done that shows that without the proper tests, physicians can’t tell the difference half the time.

Strep can cause white spots, but rarely does. Usually the throat is somewhat red and can have the red spots which are petechia. The body aches in strep are also less severe in strep and one of the defining symptoms of flu.

The only accurate way to diagnose strep is through a strep screen or a throat culture.

Strep throat symptoms include:

  • Red, sore throat with white patches
  • Headache
  • Swollen, sore glands in the neck
  • Fever
  • Red spots on the roof of the mouth
  • Painful, difficult swallowing
  • Chills
  • Fatigue
  • Nausea and possibly vomiting
  • Decreased appetite
  • Rash
  • Muscle aches, especially in the neck, and abdominal pains, especially in younger children
  • Swelling in back of mouth

We will take more tests to confirm the diagnosis that may include a throat culture, rapid DNA test or rapid antigen strep throat.

Most strep will get better in about a week to 10 days.

Your doctor will prescribe antibiotics to treat the infection. Although the symptoms may fade, the infection may remain. Please make sure to take all the antibiotics prescribed.

You may be surprised to find out that about 30 percent of people have strep in their throat at all times and it does not cause symptoms. To help reduce your child’s chances of strep, follow these tips:

  • Wash your hands
  • Don’t share food or drink
  • Avoid exposure to other people with strep
  • Replace your child’s toothbrush after starting antibiotics

Flu symptoms include:

  • Fever
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Body aches
  • Headache
  • Chills
  • Fatigue
  • Sometimes diarrhea and vomiting

We advise everyone to get the flu shot. However, if you or your child are sick with the flu, stay home, rest and avoid contact with other people. The Centers for Disease Control and Prevention recommends staying home for at least 24 hours after the fever is gone (except for medical care or other necessities). The fever should be gone without the use of fever-reducing medicine.

In some cases of the flu, you may be prescribed antiviral drugs that are prescription medicines. These aren’t sold over-the-counter and you can only get them with a prescription. The drugs aren’t antibiotics which fight against bacterial infections (strep for instance), but they fight against the virus.

You may hear someone say that their child got strep and flu at the same time. This can happen, but it’s very uncommon. Both are increase in the winter months, and symptoms such as sore throat, fever, etc. can overlap, which is likely why children are being treated for both.

Strep and flu two are entirely different things. Colds and flu always cause a sore throat, but strep is never the cause of cold symptoms.

So if your child has cold symptoms and a sore throat and gets tested for strep, it could be a false positive or it could just be a coincidence. For instance if your child has a cold or flu, then they go to the doctor or to school and are exposed to someone with strep throat. Now he or she has both. But they aren’t related.

And remember because they are different, they would each have to be treated differently and separately.

I hope this helps. We’ve been asked a lot about it lately. Stay healthy.

Pharyngitis (sore throat) and Strep Throat

Immunizations | Common Cold | Fever and Taking Your Baby’s Temperature | Ear Infections |Vomiting and Diarrhea | Croup | Pharyngitis (sore throat) and Strep Throat | Head Lice

Pharyngitis (sore throat) and Strep Throat

Sore throats (pharyngitis) that are caused by viruses are often accompanied by cold or flu symptoms. They are variably painful, last 2 – 4 days and go away on their own without antibiotics.

Strep throat is caused by a bacteria called streptococcus and requires an antibiotic for treatment. It is often, but not always accompanied by fever of varying degrees. Other common symptoms of strep throat are headache, stomach ache, vomiting, and swollen glands.

Occasionally, these are the only symptoms present.

If your child has strep throat, his tonsils are often inflamed, red and swollen, with white or yellow patches covering them. However, only mild redness may be apparent, especially early in the course of the illness. There also may be bright red spots on the roof of the mouth and a distinctive bad-breath odor.

Strep throat may also be accompanied by a fine red sandpaper-like rash that is most pronounced on the chest and abdomen. The rash can appear any time during the course of the illness and usually fades over 1-3 days. It may be followed by peeling of the palm and soles 1-3 weeks later. When the rash is present, strep throat is called scarletina or scarlet fever.

Scarlet fever is no more serious than strep throat alone; it is merely a term used to describe strep throat associated with a distinctive rash.

If you suspect your child may have strep throat, he should be seen in our office so that we can take the appropriate tests. There are two tests: a rapid strep test, which takes about 10 minutes, and a throat culture, which takes 24 hours. If either of these tests is positive, we begin treatment with Amoxicillin (if penicillin allergy is not present) for 10 days. With treatment your child should begin to show improvement in 1-3 days.

Tylenol can be given for aches, pains or fever causing discomfort. Fluids should be encouraged. Cool drinks, popsicles or Chloraseptic Lozenges can help to relieve throat pain.

Children with strep throat are contagious for 24 hours after the start of antibiotic therapy. They may return to school or day care 24 hours after beginning antibiotics and when their temperature and activity level are normal. The incubation period for strep throat is 3-7 days.

Even if your child shows improvement during the course of his treatment, it is extremely important to continue the treatment for the full 10 days to prevent the serious complications of strep throat. Serious complications of strep throat are rheumatic fever, which is an inflammation of the joints, heart and other tissues, and nephritis, which is an inflammation of the kidneys.

Strep throat symptoms in kids: Here’s what to know

Mom Sara Hartley, of Canton, Connecticut, was understandably freaked out when her 3-year-old daughter Tess had a 105-degree fever. It was nighttime and earlier that morning, Tess had been diagnosed with strep throat, an infection of the throat and tonsils caused by bacteria called A Streptococcus (group A strep), and she had started antibiotics. But what was this super-high fever?

“I was having a panic attack,” recalls Hartley.

The distraught mom called her pediatrician and was prepared to take Tess to the hospital.

“‘Breathe, Sara,’” Hartley recalls her doctor reassuring her. “‘You know it’s the strep.”

After giving her daughter ibuprofen and a bath to cool her down, Hartley says Tess’s fever decreased within half an hour.

“Having your child with that temperature, it was very stressful,” she says.

Though the most obvious symptom of strep is throat pain, it can manifest itself in many ways.

What are the signs and symptoms of strep throat in kids?

Strep causes 20% of throat infections in school-age kids from the age of 5 to 15, according to the American Academy of Pediatrics. But many parents are often confused about when a sore throat symptom is a virus or strep.

“We have certain criteria that allows us to differentiate between a bacterial strep throat and just a regular viral throat infection,” clarifies Dr. Omid Mehdizadeh, an otolaryngologist (ENT) and laryngologist at Providence Saint John’s Health Center in Santa Monica, California.

The Centers for Disease Control and Protection (CDC) list among the symptoms of strep throat:

  • Sore throat that can start very quickly.

  • Pain when swallowing.

  • Red and swollen tonsils, sometimes with white patches or streaks of pus.

  • Tiny, red spots on the roof of the mouth (the soft or hard palate).

  • Swollen lymph nodes in the front of the neck.

  • Fever.

  • Headache.

  • Nausea.

  • Vomiting.

Mehdizadeh also notes that other specific signs of strep include:

“Toddlers who get strep usually have cold-like symptoms like cough and runny nose,” says Dr. Ivanya L. Alpert, a clinical assistant professor of pediatrics at Mount Sinai School of Medicine and attending physician at Uptown Pediatrics in New York City.

When strep has unexpected symptoms

Because the symptoms are varied, sometimes parents don’t suspect strep. Chappaqua, New York mom of two Kira Hersch recalls when her then-3-year-old son Clark first got strep, he complained about stomach pain.

“He was just saying, ‘Ouchie tummy, ouchie tummy.’ I never correlated a stomachache with strep throat,” she says. “When we went to the doctor, I remember saying, ‘Maybe there’s some sort of stomach virus going around’.”

“Abdominal pain is more likely in younger children and may represent general illness due to fever,” says Mehdizadeh. “Its incidence is quite low — less than 10% — and not very specific. The pronounced throat and neck symptoms are better indicators of a strep infection.”  

Unpleasant breath (or “dragon breath,” as Hersch jokes) was another symptom she noticed.

“That’s the bacteria and the pus,” explains Mehdizadeh. “It’s an active infection inside someone’s throat, and it can generally just cause some bad breath.”

How is strep diagnosed?

If those telltale signs of strep throat present themselves, go to the doctor. He or she will do a strep test to sample the fluids in the throat.

“The doctor will take a cotton-tipped swab — basically an extra long Q-tip — and rub it along the back of your child’s throat,” says Alpert. “This takes less than five seconds. Some children will cough or gag during the test. While it can be unpleasant, it is usually not painful.”

Though the rapid strep test gives results in 10 minutes, “it can yield false negative results, so we always do a second test — a bacterial culture,” adds Alpert. “The bacterial swab and the strep test are done the same way.”

And most doctors use two swabs at the same time — one for the rapid strep test, one for the bacterial culture.

It can take between 2 to 5 days for strep bacteria to grow and provide results on a bacterial culture.

If symptoms persist for more than five days despite a negative rapid strep test, “That’s generally when we go ahead and we treat those patients with antibiotics as well,” says Mehdizadeh.

What causes strep and how long is it contagious?

How strep spreads

Day cares and schools are a hotbed for infections because there’s close contact, which is why kids are more prone to getting strep throat.

“The typical route of spread is either through mucus or nasal secretions, and they can be present in airborne droplets,” says Mehdizadeh.

How to prevent strep

The best way to prevent your child from getting strep? Through “handwashing and limiting contact when kids are contagious,” says Alpert.

How long after exposure does strep appear?

The incubation period from being exposed to an infection to the appearance of first symptoms can be between two to seven days.

How to contain strep once your child gets it

  • Limit contact with family members when kids are contagious.

  • Avoid sharing drinking glasses or utensils.

  • Wash their dishes in hot, soapy water.

  • Replace their toothbrush. It takes 24 hours on antibiotics before you’re no longer contagious, so change your child’s toothbrush to avoid reinfection. It’s a step that’s easy to forget but important to remember.

Are antibiotics necessary to get rid of strep?

Besides treating the infection, antibiotics like penicillin or amoxicillin are prescribed (or for those who are allergic to those two drugs, antibiotics like cephalexin, clindamycin, or zithromax are given).

“In cases where children simply will not take oral medication, the doctor can give them a shot of penicillin or Ceftriaxone instead,” says Alpert.

Kids older than 3
An untreated strep infection can lead to less common but more serious conditions.

“In kids older than 3, you must treat with antibiotics to prevent the complications of strep like rheumatic fever,” says Alpert.  

Rheumatic fever — more common in children from 5 to 15 — is a disease thought to be caused by a response of the immune system to the earlier strep infection and can affect the heart, joints, brain and skin, according to the CDC.

Kids younger than 3
Though kids younger than 3 rarely get rheumatic fever, “they can get other complications of strep such as bacteremia, sepsis and infection in their joints or their skin,” adds Alpert. That’s why antibiotics are prescribed. Bacteremia is when live bacteria enters the bloodstream while sepsis is a life-threatening condition where an infection triggers a body’s extreme response to an infection, according to the CDC.

Recovering from strep

If your child has been diagnosed and is recovering from strep throat, try these helpful remedies for common discomforts:

  • Offer warm liquids and broths or cold food (like ices) to ease the pain, especially if eating is the last thing your child wants to do.

  • Provide Ibuprofen for pain relief, but be sure to ask your pediatrician about the right dose for your child.

  • Try probiotics, which Alpert says help “decrease the incidence of antibiotic-induced diarrhea.

Luckily, if your child does get diagnosed with strep and antibiotics are started, symptoms tend to improve relatively quickly.

For Hartley, whose daughter had recurring strep throat for several years, “Within 24 hours of the antibiotics, you would see a drastic change in her. Tess would start feeling better because she was very sleepy and just didn’t really want to do much beforehand,” she explains.

Agrees Hersch: “When I do get that strep-positive test, I almost take a deep breath knowing that after 24 hours, he’s going to have the medicine kick in and start feeling better, not be contagious and be able to get right back to feeling better and on the right track.”

What’s Going Around | Pediatric Associates NKY

Bronchiolitis (and RSV)

We are currently seeing cases of bronchiolitis, a viral illness (sometimes caused by RSV — “respiratory syncytial virus”) that occurs most often in children under age 2. This virus typically occurs in epidemics during the winter and the early spring. “Bronchioles” are the smallest airways in our lungs, and “itis” means these airways are inflamed, or irritated, by the virus. When these airways get inflamed in young children, they often will start to “wheeze,” meaning air and the oxygen in it have difficulty getting through these narrowed, swollen airways.

With a case of bronchiolitis, your infant’s symptoms may begin with a runny nose, a fever, and a harsh, tight cough. If it progresses to wheezing, your child may start to breathe rapidly and “pull” with his/her abdomen and rib muscles with each breath. Please call us for an appointment if your child’s breathing becomes labored or difficult.

If your infant was born premature (under 32 weeks) or has cardiac or lung conditions, your child is at a greater risk of complications from RSV bronchiolitis. A product containing a specific antibody to RSV has been approved for monthly administration to help prevent RSV infection in these high-risk children. This form of antibody against RSV has the advantage of being able to be administered once a month by intramuscular injection. In large, controlled studies, this product has been shown to decrease hospitalization from RSV infections in these high-risk infants.

For more information:
See also Wheezing (Other Than Asthma)

Colds and Upper Respiratory Infections

Colds, upper respiratory infections, and URIs are common terms we use to describe viral illnesses that cause nasal congestion, runny nose, sneezing, sore throat, fever, and cough. The fever usually lasts for 2-3 days, and the cough with congestion and runny nose may last for 5-10 days. The typical preschool-age child may experience 6-10 colds per year. Most colds resolve on their own with rest and fluids, but some may lead to ear infection, sinus infection, asthma attack, or other complications. If you are concerned about the possibility of one of these complications, please have your child seen in our office for an evaluation.

For more information:
See also Colds

See also Sinus Pain or Congestion


We are currently seeing cases of croup, a viral respiratory illness that most often is caused by the parainfluenza virus. The cough and breathing that are associated with croup make it distinctly different from other viral colds or respiratory illnesses. This is because the parainfluenza virus infects and irritates the voice box, the vocal cords, and the windpipe. The cough is worse at night, and it has a distinct bark that sounds much like a seal’s bark. Associated with the barky cough, your child may have difficulty when inhaling air, making a labored and whistling sound when breathing in — called stridor. Humidified air and fluids often are the most helpful treatments.Please call the office to have your child evaluated by the doctor if he/she has symptoms of croup.

For more information:
See also Cough

It doesn’t sound like croup, see Cough

See also Croup

Tight purring sound when breathing out, see Wheezing (Other Than Asthma)




  • Colds.Most sore throats are part of a cold. In fact, a sore throat may be the only symptom for the first 24 hours. Then a cough and runny nose occur.
  • Viral Pharyngitis.Some viruses cause a sore throat without other symptoms. A cough and runny nose don’t always become part of the illness. An antibiotic won’t help.
  • Mono.Infectious Mono mainly occurs in teens and young adults. The main symptoms are sore throat, fever and widespread swollen lymph nodes. Like Strep, Mono also has pus on the tonsils. Patients with Mono also may have a large spleen. It’s located in the upper left side of the stomach. Mono is diagnosed with special blood tests.
  • Post-nasal Drip.Drainage from a sinus infection can cause a sore throat. The throat clearing that goes with the drainage may cause most of the irritation. The sinus infection is more likely to be viral than bacterial.
  • Mouth Breathing.Breathing with the mouth open during sleep can cause a sore throat. After eating breakfast, it often goes away.
  • Abscess of Tonsil (Serious).A bacterial infection of the tonsil can spread to the surrounding tissues. The main symptoms are severe trouble swallowing, fever and one-sided throat pain. Often one tonsil is much bigger/more inflamed and more painful than the other. It’s also hard to fully open the mouth. The peak age is teens.
  • Epiglottitis (Very Serious).A bacterial infection of the flap of tissue above the vocal cords. It normally covers the windpipe during swallowing. The main symptoms are severe sore throat, drooling, spitting and fever. It can shut off the airway. Needs a 911 response. Fortunately this is rare since introduction of the HIB vaccine (Heamophilus Influnza B).


  • Symptoms include sore throat, fever, headache, stomach pain, nausea and vomiting.
  • Cough, hoarseness, red eyes, and runny nose are usually not seen with Strep throat. These symptoms point more to a viral cause.
  • Scarlet fever rash (fine, red, sandpaper-like rash) is highly suggestive of Strep throat.
  • Peak age: 5 to 15 years old. Not common under 2 years old unless sibling has Strep.
  • If you think your child has Strep, call your doctor.
  • Your doctor will do a Strep test. If the test is positive, they will start treatment. There is no risk from waiting until a Strep test can be done.
  • Standard treatment is with antibiotics by mouth.

When and Whom To Call For Sore Throats
CALL 911

  • Severe trouble breathing (struggling for each breath, can barely speak or cry)
  • You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

  • Trouble breathing, but not severe
  • Great trouble swallowing fluids or spit
  • Can’t open mouth all the way
  • Stiff neck or can’t move neck like normal
  • Dehydration suspected. No urine in more than 8 hours, dark urine, very dry mouth and no tears.
  • Purple or blood-colored spots or dots on skin
  • Weak immune system. Examples are: sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
  • Fever over 104° F (40° C)
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent. Note: a Strep test alone is not urgent.
Call Doctor Within 24 Hours

  • Sore throat pain is severe and not better 2 hours after taking ibuprofen
  • Large lymph nodes in the neck
  • Pink rash that’s widespread
  • Earache or ear drainage
  • Fever lasts more than 3 days
  • Fever returns after being gone more than 24 hours
  • Age less than 2 years old
  • Close contact to a person with Strep within last 7 days
  • Sores on the skin
  • You think your child needs to be seen, but the problem is not urgent (or needs a Strep test)

Call Doctor During Office Hours

  • Sore throat is the main symptom and lasts more than 48 hours
  • Sore throat with cold/cough symptoms lasts more than 5 days
  • You have other questions or concerns

Source: adapted from Copyright 2000-2019 Schmitt Pediatric Guidelines LLC.

Vomiting and Diarrhea

We are currently seeing viral illnesses that cause vomiting and diarrhea. Usually called viral gastroenteritis, the virus causes inflammation and irritation of the stomach and the intestines, leading to vomiting and diarrhea. This illness, often called the “stomach flu” typically lasts 1-2 days, with diarrhea lasting a few days longer.

It is important to make sure that your child does not get dehydrated with this condition. Offer Gatorade, Pedialyte, or warm soda pop in small amounts every 20 minutes until your child can keep liquids down. If they are unable to keep liquids down, back off for 2 hours, then try the small amounts again. If your child has few wet diapers and does not make tears, or appears limp or lethargic, they may be dehydrated and we will need to see them in our office.

For more information:
See also Diarrhea

See also Vomiting Without Diarrhea

Strep throat in young children: A common diagnosis?

My 3-year-old son has had strep throat twice. Is this normal or should I be concerned?

Answer From Elizabeth Ristagno, M.D.

Recurrent strep throat isn’t likely a sign of an underlying problem with a child’s immune system. Children who develop strep throat repeatedly may have contact with a carrier of strep, likely at home or in a child care setting — or they may be strep carriers themselves. A strep carrier is someone who has the strep-causing bacteria, but who is not having symptoms.

Strep throat is an infection caused by a bacterium known as Streptococcus pyogenes, also called group A streptococcus. Strep throat can occur at any age, even during infancy. However, strep throat is most common in school-age children.

Children who develop strep throat may have signs and symptoms including:

  • Irritability
  • Fever
  • Refusal to eat or feed
  • Swollen glands in the neck
  • Red, swollen tonsils or throat
  • Headache
  • Stomachache
  • Nausea or vomiting
  • A fine, red rash on the torso, arms and legs

Testing for strep throat isn’t usually recommended in children younger than age 3, as the infection doesn’t occur often in this age group. Strep throat may be diagnosed with a rapid antigen test, a molecular test (PCR) or a throat culture.

Treatment for strep throat is typically a course of antibiotics. Recurrent strep throat may be treated with a different antibiotic from the one prescribed originally. In some cases, surgery to remove the tonsils (tonsillectomy) may be the most appropriate treatment.


Elizabeth Ristagno, M.D.

  • Recurring strep throat: When is tonsillectomy useful?

Aug. 03, 2021

Show references

  1. Pichichero ME. Treatment and prevention of streptococcal pharyngitis in adults and children. https://www.uptodate.com/contents/search. Accessed April 20, 2021.
  2. Elsevier Point of Care. Clinical Overview: Pharyngitis. https://www.clinicalkey.com. Accessed April 20, 2021.
  3. Streptococcal infections. Merck Manual Professional Version. https://merckmanuals.com/professional/infectious-diseases/gram-positive-cocci/streptococcal-infections. Accessed April 20, 2021.
  4. AskMayoExpert. Streptococcal pharyngitis. Mayo Clinic; 2020.
  5. Strep throat: All you need to know. Centers for Disease Control and Prevention. https://www.cdc.gov/groupastrep/diseases-public/strep-throat.html?CD. Accessed April 21, 2021.

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90,000 diarrhea with angina in a child – 25 recommendations on Babyblog.ru

Angina in children – treatment, symptoms, signs,

Source: http: //zdravotvet.ru/angina-u-detej-lechenie-simptomy-priznaki-foto/
An article in which it seemed to me that everything was chewed …

Angina is an acute infectious disease when there is inflammation of the palatine tonsils in the oral cavity. Banal microorganisms – streptococci, staphylococci, less often other pathogenic bacteria and viruses (pneumococci, adenoviruses, spirochetes, fungal flora) when favorable conditions for reproduction arise – hypothermia, viral infections, poor nutrition, overwork, are the causative agents of angina in a child, the treatment of which depends on the type of infectious agent, the severity of the inflammatory process, as well as the age of the child.How to treat a sore throat in a child – this article.

Causes of angina in children

One of the most common diseases in children during the autumn-winter season is angina. If a child eats poorly, or eats not entirely healthy foods, rarely is in the fresh air outside the city, is not fond of active physical training, for such a child the cold is a serious stress for the immune system and any hypothermia, frozen feet in the cold, ice cream or cold drink – provoke the reproduction of pathogenic microorganisms in the oral cavity, more precisely in the lacunae of the tonsils.So, the provoking factors in this case are: weakening of the child’s immunity from overwork, irrational, inadequate nutrition, transferred viral infections – ARVI, influenza, parainfluenza, as well as another option for the development of angina, an inflammation focus in another organ can serve, for example, if the child has sinusitis or sinusitis, otitis media, caries, or adenoids. general or local hypothermia, that is, finding the child for a long time at a low temperature or consuming cold drinks and foods.In addition, with close contact with a sick person, a child can become infected by airborne droplets, that is, pathogenic bacteria penetrate from the outside when coughing and sneezing, through shared dishes or contaminated food (see symptoms of food poisoning in a child). Parents often cannot independently identify the onset of a sore throat in a child, since children do not always complain of a sore throat, and all signs of sore throat – high fever, runny nose, red throat – are perceived as signs of flu or SARS.Although angina is considered a very common disease in children, it should not be treated as a common cold. Improper treatment can lead to chronic tonsillitis, which in turn provokes the occurrence of more than 100 other dangerous diseases such as allergies, rheumatoid arthritis, kidney, vascular and heart disease. As soon as a child develops alarming symptoms, you should immediately consult a doctor and do not rely on only folk remedies for treating a red throat.

When is the child’s hospitalization required?

Concomitant diseases – renal failure, diabetes mellitus, blood clotting disorders, etc.Complicated tonsillitis – phlegmon of the neck, abscesses, rheumatic heart disease. Severe intoxication in a child – confusion, respiratory failure, fever not knocked down by antipyretics, vomiting and nausea, convulsions. With angina of children under one year old, many doctors strongly recommend treating in a hospital, however, it is better to treat uncomplicated angina at home (the child is at home, in a calm atmosphere, there is no likelihood of a hospital infection).

Types and symptoms of angina in children

Depending on how deeply the tonsils in a child are inflamed in medicine, there are several types of tonsillitis: catarrhal tonsillitis lacunar tonsillitis follicular tonsillitis ulcerative-membranous Also classified into: Primary tonsillitis – simple tonsillitis with general intoxication and signs of tissue damage to the pharyngeal ring Secondary tonsillitis – occurs against the background of some acute infectious diseases – scarlet fever, diphtheria, infectious mononucleosis in children, etc., as well as for blood diseases – agranulocytosis, leukemia, etc.

Specific angina – fungal lesions, spirochete. Depending on the causative agent of the inflammatory process, they are classified into: bacterial, purulent sore throat fungal diphtheria viral (enterovirus, herpetic, adenoviral)

But in all cases, the most basic symptom is a sore throat when swallowing, a high body temperature, it can rise from 38 to 40C, while the child sharply weakens, is capricious, he has a headache, vomiting and diarrhea from severe intoxication are possible.When examined during a sore throat in a child, the doctor sees enlarged tonsils, they become loose, bright red, plaque appears in the grooves of the tonsils on the mucous membrane, which can be removed with a cotton swab. In addition to pain, temperatures in children with angina increase and the cervical and submandibular lymph nodes become painful (in no case should they be warmed up with compresses and other procedures). The inflammatory process in sore throat always affects the vocal cords, therefore, the appearance of a hoarse voice in a child is also a symptom of sore throat.Usually this disease does not last more than a week or 10 days; successful treatment depends on correct diagnosis and timely adequate treatment. Therefore, the doctor first of all determines what kind of angina the child has and only then prescribes treatment. It is imperative to contact a pediatrician, since it is not possible on your own to distinguish plaque on the tonsils from stomatitis, fungal disease, diphtheria, etc., and, accordingly, the treatment of viral, bacterial or fungal tonsillitis will be different, in addition, the doctor prescribes tests and determines the severity of the child’s condition, the need in hospitalization.

Treatment of catarrhal sore throat in children

With catal sore throat, the child usually has a low temperature, the child becomes lethargic, lethargic, feels pain during swallowing, nausea. The inflammatory process, soreness of the lymph nodes with this type of sore throat are not intense and most often such sore throat occurs after ARVI or influenza. Therefore, the use of antibiotics for such a sore throat depends on the child’s history, clinical picture and the result of an express test, which will determine the causative agent of inflammation.The decision to take antibiotics is made by the attending pediatrician. For catarrhal angina, treatment with oral antibiotics in children can be replaced or supplemented with a topical spray such as Bioparox. A few decades ago, with a slight sore throat, treatment was carried out only with folk remedies, gargling, if the child is strong, eats well, his immune system itself coped with the disease. But times have changed, now children are so weak that they cannot do without antibiotics.The main condition in the treatment of catarrhal sore throat in children is bed rest, copious warm drinks, frequent gargling or throat treatment with various sprays in young children. With adequate treatment, this form of acute tonsillitis resolves in 5-7 days.

Treatment of follicular and lacunar tonsillitis in children

These forms of angina in children are rather difficult, as they are accompanied by fever, and the body temperature can be above 40C. A distinctive feature of follicular sore throat is that the tonsils are covered with yellow pustules (follicles up to 3 mm), as if creating a “starry sky”, and with lacunar angina – with a white-yellow purulent bloom in the lacunae, which are located between the lobes of the tonsils.Treatment for both sore throats is identical. The main thing is to choose an antibiotic that will surely help to cope with the causative agent of sore throat. The best option is to pass a smear for bacterial culture, which will determine the sensitivity of bacteria to a specific antibiotic. Or the doctor will empirically prescribe a broad-spectrum antimicrobial agent. Usually, if a child has a sore throat of 1-3 years old, treatment is recommended to be carried out in a hospital, under the supervision of a pediatrician. But today this is not necessary – attentive, caring parents can provide the best care for the baby at home, and the doctor’s control is determined by the financial condition of the family – you can always call a paid pediatrician to the house, and when an injections are prescribed and necessary, honey.sister. However, in the case of a serious condition of the child and the presence of concomitant diseases, the decision is made by the doctor and the parents in favor of the hospital. Older children can carry out treatment at home, on an outpatient basis, provided that the sick child is isolated from other children, since purulent sore throat is a contagious disease.

How to distinguish viral sore throat from bacterial and how to treat it?

With viral tonsillitis, there are no purulent deposits on the tonsils, the throat is only swollen and bright red.Before the onset of viral sore throat, the child feels the signs of a viral infection – a runny nose, dry cough, high fever, lacrimation, sore throat, then the pharynx worsens. With bacterial – only local manifestations (edema, plaque on the tonsils, pain) and a sharp rise in temperature with symptoms of intoxication. Herpetic sore throat is characterized by the presence of vesicles on the oral mucosa and on the tonsils, when the vesicles open, a transparent content is found in them, ulcers then form in place of the vesicles.

Treatment of herpetic sore throat is performed with antiviral agents both for local treatment and oral administration – Valacyclovir (Valtrex, Valvir, Virdel, Vairova), Acyclovir, Famciclovir. As for the use of other antiviral agents and immunostimulants, their use in children should be treated very carefully (see antiviral drugs for ARVI and influenza), the safest and most actively prescribed of them are Hippferon, Viferon, Genferon-light.

How to treat angina in a child?

For a speedy recovery of the child, all the recommendations of the attending pediatrician should be strictly followed.Treatment of angina consists in drinking plenty of water, taking antibiotics, antipyretics, antihistamines, gargling, vitamin therapy and taking eubiotics.


No warming procedures: compresses, hot steam inhalations, warming creams and ointments in the neck area are unacceptable for angina! Gargle with sore throat

One of the directions in the treatment of angina in children is gargling for older children and treatment with sprays and aerosols of young children.However, this is only an auxiliary method, since the main treatment is the intake of antibacterial drugs.

Important! Do not use the same remedy several times in a row, if you recently gave your child Faringosept during ARVI, use Ingalipt, Lugol spray or other remedy next time. You can gargle with various ready-made pharmacy products, such as sprays (used for children after 3 years old) – Lugol spray, Hexoral spray, Tantum Verde (weak), Ingallipt, Hexasprey (after 6 years).And also solutions – 0.01% solution of Miramistin, hydrogen peroxide – 2 tbsp. tablespoons in a glass of water, a weak solution of potassium permanganate, a solution of Iodinol (1 tablespoon for 1 glass of warm water), dissolving 2 tablets of furacilin in a glass of water. Decoctions of herbal herbs – sage, chamomile, calendula or ready-made collections of these herbs Ingafitol, Evkarom, Rotokan, as well as a simple solution of salt and soda (0.5 teaspoon each) and a few drops of iodine are well disinfected. But many pediatricians do not recommend lubricating the tonsils with antiseptics, since this damages the protective layer of the mucous membrane, which worsens the situation with purulent sore throat.In older children with angina, you can use absorbable tablets and lozenges – Faringosept, Stopangin, Strepsils (after 5 years), Hexoral tabs, Grammidin.

“Sore throat and stomach”, or what do you know about adenovirus

During the period of seasonal ARVI, cough and sore throat is an “expected” phenomenon. But what if traditional respiratory symptoms are combined with diarrhea or vomiting? Perhaps it is an adenovirus infection.

Special features

Adenovirus, unlike many respiratory viruses, affects not only the respiratory tract, but also the mucous membrane of the small intestine.In addition, the conjunctiva of the eye is “under attack”.

This results in:

  • profuse mucous nasal discharge,
  • for tickling and sore throat,
  • cough (first dry, and later with sputum secretion),
  • symptoms of conjunctivitis, in the form of redness of the eyes, lacrimation, sensation of dryness and “sand” in the eyes,
  • as well as abdominal pain, diarrhea, vomiting
  • and fever, the duration of which can be up to 2 weeks.

At the same time, if intestinal symptoms for the entire infection may not develop, then “characteristic” eyes are an important distinguishing feature of adenovirus.

Where can you get infected

Adenovirus is highly infectious and resistant in the external environment. And sick people or household items on which the virus remains active for up to 8 days can become a source of infection.

You can get infected:

  • when a patient coughs and sneezes,
  • eating food prepared by him without observing sanitary standards (thorough hand washing is necessary),
  • and even through contact with the feces of an infected person (for example, when changing a diaper to an infected child).

It is possible to “catch” the virus even in the pool, with insufficient water disinfection. And, obviously, this viral infection is not uncommon in children’s groups.

How dangerous is it

Adenovirus infection, in most cases, does not pose a threat to health and life. And it usually ends without consequences after 7-14 days. Whereas in debilitated patients, the infection can be prolonged and reach 6 weeks.

In the same category of patients, complications most often develop, in the form:

  • pneumonia,
  • otitis media,
  • bronchospasm
  • severe keratoconjunctivitis.

However, Rospotrebnazor experts note that complications of adenovirus infection are always associated with the addition of pathogenic bacterial flora (staphylococci, streptococci and others).

How to identify adenovirus

The classic symptoms of adenovirus infection, as a rule, do not require additional tests. And the help of laboratory diagnostic methods is mainly resorted to at the earliest stage of the infectious process or in case of doubt about the diagnosis.

The most informative analysis in this case is PCR diagnostics of the material (smear from the throat or feces) for adenovirus.

The study can be ordered separately or immediately in combination with other ARVI viruses (for example, “ARVI-Screen”), which will allow you to immediately carry out differential diagnostics. True, the PCR technique dramatically loses its reliability if treatment has already begun, both local (rinsing, sprays) and general ones.

A blood test for IgA antibodies to adenovirus is devoid of these shortcomings.

They appear in the blood at the initial stage of the disease, and for some time continue to circulate after recovery.

However, children, as you know, do not like blood tests, so this examination format is more suitable for adults.

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90,000 Dangerous symptoms of the Indian strain of coronavirus named: Society: World: Lenta.Common crawl en

The Indian strain of the coronavirus, called the delta variant or B.1.617, may show four new dangerous symptoms. This is reported by the Express edition with reference to the infectious disease doctor from the Indian city of Chennai Abdul Ghafur.

According to the physician, the symptoms of the delta variant of COVID-19 are similar to those of a cold: a headache, runny nose and sore throat may indicate the presence of an infection. However, to date, four new symptoms of the disease have been identified: diarrhea, hearing impairment, severe stomach upset and blood clots leading to gangrene.

Doctors note the unpredictability of the new variant of the virus and state that any of the above symptoms could indicate an infection. “We need more research to analyze whether these new clinical manifestations are related to B.1.617,” Ghafoor emphasized.

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The publication also notes that six leading doctors observing patients throughout India have identified the following most common symptoms in patients with the Indian strain: pain abdominal pain, nausea, vomiting, loss of appetite, hearing loss and joint pain.

Meanwhile, in the UK, the publication points out, the first data suggests that the delta variant, which is currently the most common among COVID-19 patients, carries a higher risk of hospitalization. “This option seems to work a little differently,” said British epidemiologist and professor Tim Spector.

He noted that young people infected with B.1.617 are likely to experience “milder symptoms” which may “feel like a bad cold or some strange feeling of sickness.”If such symptoms are found, Professor Spector strongly recommends taking a coronavirus test.

The delta variant of the coronavirus has spread to more than 60 countries in the past six months. The Indian strain is believed to be 60 percent more infectious than the previous dominant COVID-19 strain. On June 21, the Indian authorities announced the emergence of a new strain of COVID-19 – “delta plus” (B.1.617.2.1). There are already 20 known cases of infection. The new subspecies, according to epidemiologists, is distinguished by the presence of the K417N mutation in the spike protein.It is able to reduce the activity of antibodies of recovered and vaccinated people.

Earlier, infectious disease doctor Svetlana Malinovskaya spoke about a new deadly coronavirus tactics. According to her, the disease began to act more aggressively and unpredictably.

Stories without censorship and prohibitions – in the “Tape of the Bottom” in Telegram

90,000 Enterovirus infections are very insidious | Luhansk Oblast, Vyskovo-Civil Administrative Administration

Enterovirus infections – a large group of acute infectious diseases characterized by fever and polymorphism of clinical symptoms caused by damage to the central nervous system, cardiovascular system, gastrointestinal tract, muscular system, lungs, liver, kidneys, etc.organs.

The causative agents of the disease are the enteroviruses Coxsackie A, B and EKHO, which persist for a long time in the environment and food, are sensitive to heating above 56 ° C, chlorine-containing disinfectant solutions, and ultraviolet radiation.

The source of infection is a sick person or a virus carrier.

Mechanisms of transmission of infection – fecal-oral, airborne, transplacental.

Susceptibility to enterovirus infections is general, but children aged 3 to 10 years are more likely to get sick.The infection is highly contagious, seasonality is spring-summer-autumn. Immunity is unstable, type-specific.

Entrance gate of infection – mucous membranes of the upper respiratory tract or digestive tract, where the virus multiplies, accumulates and causes a local inflammatory reaction, which is manifested by symptoms of herpetic sore throat, acute respiratory infections, pharyngitis or intestinal dysfunction.

The incubation period for lasts from 2 to 7 days. The onset of the disease is acute, sudden, violent, the temperature rises rapidly to 39 ° -40 ° C, often with chills.Patients are worried about severe headache, dizziness, sleep disturbance. The patient’s appearance is characteristic – bright cheeks and lips, conjunctival hyperemia, vascular injection of the sclera, pale nasolabial triangle. Abdominal pain, nausea, and vomiting, diarrhea, or constipation are common. The course of most forms is benign, lasting 3-7 days, but prone to relapses and undulating course.

There are several clinical forms of enterovirus infection , which can be either the only manifestation of the disease or be combined with other forms.

1. Herpetic sore throat . On the first day of the disease, red papules appear, which are located on the moderately hyperemic mucous membrane of the palatine arches, uvula, soft and hard palate, quickly turn into vesicles 1-2 mm in size, in numbers from 3-5 to 15-18, not merging with each other. After 1-2 days, the bubbles open with the formation of erosion or dissolve without a trace by 3-6 days of illness. Pain when swallowing is absent or insignificant, sometimes salivation appears.The enlargement of the cervical and submandibular lymph nodes is small, but their palpation is painful.

2. Epidemic myalgia (Bornholm’s disease, “devil’s dance”, pleurodynia) is characterized by acute pain localized in the muscles of the anterior abdominal wall of the abdomen, lower chest, back, extremities. The pains are paroxysmal in nature, lasting from 30-40 seconds to 15-20 minutes, repeat for several days, may be recurrent, but with less intensity and duration.

Meningeal syndrome persists from 2-3 days to 7-10 days, the rehabilitation of the cerebrospinal fluid occurs in the 2-3rd week. Residual effects are possible in the form of asthenic and hypertensive syndromes.

Other neurological symptoms in meningitis of enteroviral etiology may include disorders of consciousness, increased tendon reflexes, absence of abdominal reflexes, nystagmus, clonus of the feet, and short-term oculomotor disorders.

4. Paralytic forms of enterovirus infection differ in polymorphism: spinal, bulbospinal, pontine, polyradiculoneuric forms can develop.More often than others, the spinal form is found, which is characterized by the development of acute flaccid paralysis of one or both legs, less often – of the hands with severe pain syndrome of a muscular nature. The course of these forms is easy, does not leave persistent paresis and paralysis.

5. Enterovirus fever (minor illness, 3-day fever) is the most common form of enterovirus infection, but it is difficult to diagnose with sporadic morbidity. It is characterized by short-term fever without pronounced symptoms of local lesions.It proceeds with moderate general infectious symptoms, the state of health is slightly disturbed, there is no toxicosis, the temperature lasts 2-4 days. It can be clinically diagnosed in the presence of an outbreak in the collective, when other forms of enterovirus infection are encountered.

6 . Enterovirus exanthema (“Boston fever”) is characterized by the appearance from 1-2 days of illness on the face, trunk, limbs of pink rashes, maculopapular or maculopapular, sometimes there may be hemorrhagic elements.The rash lasts 1-2 days, less often – longer and disappears without a trace.

7. Intestinal (gastroenteric) form. Proceeds with watery diarrhea up to 5-10 times a day, abdominal pain, flatulence, infrequent vomiting. Symptoms of intoxication are moderate. In children under 2 years of age, intestinal syndrome is often combined with catarrhal symptoms from the nasopharynx. The duration of the disease in young children for 1-2 weeks, in older children 1-3 days.

8 .Respiratory (catarrhal) form is manifested by mild catarrhal symptoms in the form of nasal congestion, rhinitis, dry rare cough. On examination, hyperemia of the mucous membrane of the oropharynx, soft palate and posterior pharyngeal wall is revealed. Mild dyspeptic disorders may occur. Recovery occurs in 1-1.5 weeks.

9 . Myocarditis, encephalomyocarditis newborns, hepatitis, kidney damage, eyes (uveitis) – these forms of enterovirus infection in children are rare.Clinical diagnosis of them is possible only in the presence of manifest forms of enterovirus infection or epidemic outbreaks of the disease. More often they are diagnosed during virological and serological studies.

Preventive measures

1. Isolation of patients.

2. Avoid large gatherings of people (shopping centers, markets, public transport).

3. Frequent, thorough hand washing with antibacterial soap, using antibacterial wet wipes outside the home.

4. Thoroughly washing or scalding vegetables and fruits before eating.

5. Do not drink tap water without boiling it.

6. Frequent ventilation of the room and wet cleaning with the addition of detergents.

7. Do not swim in stagnant water.

8.Specific prophylaxis (vaccine) has not been developed.

At the first signs of illness, you should immediately seek medical help, do not self-medicate!

Chief Physician, LOCH Ocheretnaya Oksana Nikolaevna

90,000 How to distinguish coronavirus from colds and flu

Coronavirus causes a disease called COVID-19.The World Health Organization has declared it a pandemic – a strong and widespread epidemic in many countries. The number of detected infections is growing every day, as is the death toll. Complicating the diagnosis of the disease is that its symptoms are quite similar to those of the flu, colds and allergies. How can we distinguish coronavirus from them?

COVID-19 has three symptoms that together are not common to the other three diseases. People with coronavirus tend to have a fever, dry cough, and shortness of breath.The first two symptoms together are with flu, and less often with allergies. With a cold, intense fever is rare, and a dry cough, as a rule, does not bother a very patient. Breathing problems can only be with allergies: with colds and flu, such symptoms are not observed.

Headaches, sore muscles and throat, and fatigue can also occur (albeit infrequently) with COVID-19. On the other hand, these symptoms are common with the flu. Muscle and throat soreness is also common with colds and never occurs with allergies.The head, on the other hand, can sometimes hurt with allergies and rarely with a cold.

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Diarrhea with coronavirus is rare, although such cases have also been described. Flu diarrhea only affects children. Rarely, with COVID-19, there is also a runny nose. And with colds and allergies, this is a common thing. Sometimes a runny nose is observed with the flu. Finally, with coronavirus and flu, people do not sneeze, unlike those with colds and allergies.

Here are the signs of four diseases in one table.

Business Insider used data from the World Health Organization, the US Centers for Disease Control and Prevention and the American College of Allergy, Asthma and Immunology to compare symptoms.

According to the latest data, almost 160,000 cases of coronavirus infection were recorded in the world, 6,021 people died. In Russia, 63 people fell ill, three have already recovered.

“Immunity does not recognize coronavirus yet”: the head of the WHO in Russia on the secrets of COVID-19 and the rules of behavior in a pandemic

rings, most often of the palatine tonsils, caused by streptococci or staphylococci, less often by other microorganisms, viruses and fungi, Angina is also called an exacerbation of chronic tonsillitis.

The most common vulgar (common, banal) tonsillitis: catarrhal, lacunar, follicular, fibrinous, phlegmonous, herpetic and ulcerative membranous. In recent years, all types of tonsillitis are called Acute tonsillitis.


Catarrhal sore throat develops acutely, the patient complains of a burning sensation, dryness, perspiration in the throat, and then there is a slight pain when swallowing. The clinic of asthenic-vegetative syndrome is being observed.The temperature is usually subfebrile. On examination, the tonsils are hyperemic, slightly enlarged, in places they can be covered with a thin film of mucopurulent exudate. Tongue dry, coated. There is a slight increase in regional lymph nodes. Usually clinical manifestations disappear within 3-5 days.


Follicular tonsillitis begins with an increase in body temperature to 38-39 ° C. And the occurrence of severe sore throat when swallowing, often radiating to the ear.Depending on the severity of intoxication, there is a headache, back pain, fever, chills, general weakness .. Most often, the submandibular lymph nodes are enlarged, their palpation is painful. There is hyperemia of the soft palate, tonsils, on the surface of which numerous round, somewhat raised yellowish or yellowish-white dots are visible. The duration of the disease is 5-7 days.


Lacunar angina proceeds with symptoms similar to follicular, but more severe.With her, against the background of the hyperemic surface of the enlarged tonsils, yellowish-white plaques appear. The duration of the disease is 5-7 days ..


Fibrinous tonsillitis is characterized by the formation of a single continuous plaque of whitish-yellow color, which can extend beyond the tonsils. This type of angina can develop from a lacunar or run on its own with the presence of a continuous film already in the first hours of the disease. The latter case is characterized by an acute onset with high fever, chills, severe symptoms of general intoxication, sometimes with signs of brain damage.

Phlegmonous (intratonsillar abscess)

Phlegmonous tonsillitis is relatively rare. Its development is associated with purulent fusion of the tonsil area. The defeat is usually one-sided. The amygdala is enlarged, hyperemic, its surface is tense, painful on palpation. On examination, a forced position of the head is characteristic, an increase in regional lymph nodes, painful on palpation. Complaints of sore throat when swallowing, talking; headache, fever up to 39-40 ° C, symptoms of general intoxication.Pharyngoscopy: the amygdala is enlarged, hyperemic, its surface is tense, painful on palpation. Characterized by trismus of the masticatory muscles, an asymmetric pharynx due to the displacement of the uvula and tonsil to the healthy side. The mobility of the soft palate is limited.


Herpetic sore throat often develops in childhood. Its causative agent is the Coxsackie A virus. The disease is highly contagious, transmitted by airborne droplets and rarely by fecal-oral route.Herpetic sore throat debuts acutely, fever appears, the temperature rises to 38-40 ° C, sore throat occurs when swallowing, headache, muscle pain in the abdomen; there may be vomiting and diarrhea. In the area of ​​the soft palate, uvula, on the palatine arches, on the tonsils and the back of the pharynx, small reddish bubbles are visible. After 3-4 days, the bubbles burst or dissolve, the mucous membrane takes on a normal appearance.

Ulcerative membranous

The causative agent of ulcerative-membranous sore throat is considered to be the symbiosis of the spindle-shaped bacillus and oral spirochetes, which often inhabit the oral cavity of healthy people.Morphological changes are characterized by necrosis of the surface of one amygdala with the formation of an ulcer. The patient complains of a feeling of awkwardness and a foreign body when swallowing, putrid breath, increased salivation. Body temperature, as a rule, is not elevated. Moderate leukocytosis in the blood. Regional lymph nodes are enlarged on the affected side. The duration of the disease is from 1 to 3 weeks, sometimes it lasts for several months.

In more than 50% of angina [1] cases, the main etiological role belongs to group A β-hemolytic streptococcus., adenoviruses, herpes virus, Coxsackie Enterovirus, Vincent’s spirochete, Candida fungi.

Predisposing factors: local and general hypothermia, decreased local and general immunity, trauma to the tonsils, condition of the central and autonomic nervous system, impaired nasal breathing, chronic inflammatory processes in the oral cavity, nose and paranasal sinuses [1] .

Clinical manifestations

In acute primary tonsillitis, the clinical picture is manifested by symptoms of tonsil lesion – varying degrees of severity of sore throat when swallowing, signs of general intoxication, hyperemia, swelling of the tonsils, fibrinous-purulent plaque in the mouths of the lacunae, grayish-yellow plaque, under which superficial pores are found regional lymphadenitis.

Sore throat begins with a sore throat and a sharp rise in body temperature to 39-40 ° C (sometimes up to 41 ° C). The sore throat is usually severe and severe, but may be mild. Lymph nodes are enlarged. They are well felt under the lower jaw and at the same time cause painful sensations. Angina can also occur at lower body temperatures – from 37 to 38 ° C, but with more damage to the throat.

Sore throat often occurs with ARVI, especially of adenoviral origin, but lymph nodes are relatively rarely enlarged.


The main diagnostic technique for recognition is examination of the pharynx – pharyngoscopy, as well as assessment of complaints and anamnesis of the disease. Also, to determine the type of infection, a smear of mucus or pus is taken, which is taken from the tonsils. The biomaterial is sent for different types of analyzes by the decision of the attending physician.

Of the complications of angina, the most common are acute otitis media, acute laryngitis, laryngeal edema, phlegmon of the neck, periopharyngeal abscess, acute cervical lymphadenitis.


Basic recommendations: bed rest in the early days of the disease, a non-irritating, soft and nutritious diet, vitamins, plenty of drink.

In the treatment of sore throat, the choice of drug depends on the type of microbe that caused the disease. The type of drug, dosage and method of administration are determined by the attending physician.

  • In the treatment of bacterial tonsillitis, various types of antibiotics and antimicrobial drugs of synthetic origin are used (depending on the sensitivity of the microbe and the patient’s response to drugs), various local antiseptics, which are produced in the form of a spray or aerosol, as well as tablets, lozenges and lozenges.
  • In the treatment of fungal tonsillitis (this disease is provoked mainly by a fungus from the genus Candida), antifungal drugs are used. Fungal sore throat often occurs after prolonged antibiotic treatment.
  • Treatment of viral tonsillitis involves the use of anti-inflammatory drugs, as well as symptomatic agents.

Often with angina of any origin, the otolaryngologist prescribes various antiseptic and cleansing solutions for rinsing the throat, which are prescribed for use every hour.Recently, experts believe that gargling does not speed up the healing process, but it may make the state of health easier

At temperatures above 38 degrees, antipyretic drugs can be taken. With bacterial etiology of angina, in many cases, an antibiotic is prescribed that is active against the coccal flora (streptococci and staphylococci), the course is carried out for at least 7 days,

To prevent tonsillitis, timely sanitation of foci of chronic infection (carious teeth, chronic tonsillitis, purulent lesions of the paranasal sinuses, etc.) is necessary.), elimination of the causes of impaired nasal breathing.

Angina can be contagious (especially with scarlet fever), so the patient should be placed in a separate room, often ventilated and wet cleaned, not allowing children and the elderly to visit him. For the patient, special dishes are allocated, which, after each use, are boiled or poured over with boiling water.

Throat rinses:

  1. Furacilin solution (ready-made pharmaceutical solution does not need to be diluted)
  2. Chlorhexidine solution (adults – without dilution, children – one part chlorhexidine 2 parts water)
  3. Alcohol chlorophyllipt solution (one teaspoon per 100 ml of water)
  4. Pharmacy propolis tincture (5-10 drops per 100 ml of water)
  5. Decoctions of herbs (chamomile, calendula, sage, mixed or separately)

For effective rinsing:

  1. Solution must be warm
  2. One rinsing episode must be at least 30 seconds in duration
  3. After rinsing, it is advisable to stop drinking or eating for an hour.

It is necessary to gargle the throat in a course (at least 3 times a day for 5 days)

  • Fennel fruit -10.