Sore throat and rash on arms and legs. My hand hurts. Medical information portal

Infantile roseola (sudden exanthema)

Herpes virus type 6 (HHV-6) causes roseola infantum (sudden exanthema). Temperatures above 39°C last for 3-4 days, temperatures below 39°C can last up to 8 days. After a drop in temperature, a bright macular or maculopapular rash appears on the skin of the face, neck or torso. The rash does not itch. Sometimes the cervical lymph nodes are enlarged, swelling around the eyes and red papules on the soft palate (Nagayama spots). Fever may be accompanied by diarrhea, cough, runny nose and headache. The rash goes away in 3-4 days without treatment.

Important. The rash that appears after the temperature normalizes is frightening: “First the temperature, and now the rash!” In fact, this is a sign of the end of the disease.

Febrile seizures in children under 2 years of age, fever without a focus of infection, and Epstein-Bar negative mononucleosis are often caused by herpes virus infection type 6 (HHV-6). In rare cases, the virus causes fulminant hepatitis and encephalitis, as well as Rosai-Dorfman syndrome (generalized lymphadenopathy).

ECHO-exanthema (infectious exanthema) proceeds similarly - the rash appears after the temperature normalizes. With ECHO exanthema, herpetic sore throat and diarrhea are common.

Treating a rash in the throat

Based on the results of diagnostic studies, therapy is selected. Treatment tactics directly depend on the causes of the rash:

1. Antibiotics are required for scarlet fever. Also, this disease requires inhalation using a nebulizer. This device provides complete irrigation of all areas of the respiratory tract.
2. To combat sore throat, antibiotics and local drugs are used. The doctor must prescribe plenty of fluids and rinses. Inhalations with solutions of ingalarom and ventalinom are often prescribed.
3. When chickenpox develops, you need to get rid of the white coating. For this purpose, a soda solution is used. With its help, it is possible to eliminate the symptoms of inflammation and infiltration. In addition, be sure to gargle.
4. In case of allergic reactions, rinsing is necessary. For this purpose, infusions of calendula and chamomile are used. It is important to ensure that there are no allergies to them.
5. Viral pathologies are treated with drugs such as oseltamivir and zenamivir.
6. Herpetic stomatitis can be cured with the help of special herpes remedies.
7. Herpetic sore throat is treated in the same way as other viral pathologies. It is important to adhere to a diet that involves excluding spicy, salty and hot foods. This helps avoid additional irritation.

A rash in the throat can be a symptom of a variety of pathologies. In most cases, it indicates simple diseases - viral infections or sore throat. However, sometimes this symptom indicates dangerous illnesses. In any case, it is very important to consult a doctor promptly. Based on the results of a comprehensive diagnosis, the specialist will select adequate therapy.

Rubella

With rubella, the eyes are reddish, there is a slight runny nose and cough. General health does not suffer. Sometimes, violet spots (Forchheimer's spots) on the soft palate. The lymph nodes behind the ears and on the sides of the neck are greatly enlarged. A pinkish-red, small-spotted rash appears after the temperature rises to 37.0-37.7°C. The first to appear is a bright blush on the cheeks. Within a day, the rash covers the face, chest, abdomen, legs and arms. There is little rash in places of natural folds (folds). The rash becomes brighter after swimming. Itching is mild. After 5 days, the rash disappears without a trace. Older children and adults may experience joint pain.

Important. There is NO measles without cough and conjunctivitis.

Measles begins with a high fever, severe runny nose, cough and conjunctivitis. After 2-3 days, small white-gray grains appear behind the cheek - Filatov-Koplik spots. On the 3-4th day of high fever, a pink-red spotted or maculopapular rash appears on the bridge of the nose and behind the ears. Elements of the rash tend to merge and turn pale when pressed. On the first day, the rash affects the face, the second day - the torso, the third day - the legs and arms. When the rash appears on the extremities, on the face it already fades - it becomes burgundy-brown with isolated hemorrhages and peeling. Feet and palms do not peel off during measles. Itching is mild.

How to get rid of ulcers on the tonsils for pregnant women and children

These are special categories of patients for whom many medications are contraindicated, while the immune system is not working at full strength. For pregnant women, sore throat is dangerous at any stage. In the first trimester, the disease can cause severe toxicosis, the threat of miscarriage, or disrupt the development of the unborn child.

At any time, typical complications of the disease may occur, as well as a weakening of labor due to a general decrease in the body’s defenses. Ideally, chronic tonsillitis is treated at the stage of pregnancy planning.

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In a situation where abscesses on the tonsils appear in a pregnant woman, the therapist and obstetrician-gynecologist decide how to treat the disease. First of all, topical medications, antiseptic and anti-inflammatory rinses will be prescribed.

If in a serious situation the doctor prescribes antibiotic treatment, you should not refuse: they will bring more benefit than harm.

Pustules in the throat in infants under one year of age are usually treated in a hospital setting: the risk of rapid development of edema and severe intoxication is too great. In children older than one year, it is somewhat easier to treat ulcers that appear on the tonsils: they have already developed their own immunity. But he is still too weak to get rid of the pus without antibiotic therapy.

Children under 3 years of age are very prone to allergies, therefore, without consulting a pediatrician, not only antibiotics, but also herbal remedies should not be used to treat them.

To reduce the temperature from 38 °C, both pregnant women and babies are prohibited from taking aspirin . Only paracetamol-based drugs are allowed. You cannot steam your feet, do steam inhalations, or perform any other warming procedures.

Erythema infectiosum (parvovirus B19 infection)

Against the background of a low temperature, a spotted, papular and even urticarial rash appears. Parvovirus infection is often mistaken for hives. BUT. Antihistamines and systemic glucocorticosteroids are ineffective for parvoviral exanthema. First, a bright, macular rash appears on the face (a symptom of “slapped cheeks”), then a maculopapular rash appears on the extremities (including the palms and soles) and torso. The nasolabial triangle is usually pale. Itching is mild. Joints often hurt. The rash of erythema infectiosum may reappear after disappearing.

Important. Parvovirus B19 infection is dangerous for children with aplastic anemia, because it causes a transient aplastic crisis.

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Scarlet fever

Scarlet fever is caused by some strains of group A hemolytic streptococcus. Scarlet fever occurs at high temperatures in the form of a sore throat with a pinpoint rash against the background of a hyperemic rut. Pale nasolabial triangle. A “raspberry” tongue is characteristic. On the 7-10th day, lamellar peeling of the hands and feet develops. These signs are quite characteristic for the diagnosis; it is confirmed by the release of GABHS or an increase in ASLO. Neutrophilic leukocytosis is common.

Treatment of scarlet fever: penicillin or ampicillin intramuscularly, amoxicillin orally 50 mg/kg per day (Flemoxin Solutab). About scarlet fever, see Temperature, sore throat, rash - scarlet fever.

Borreliosis

Borreliosis (Lyme disease) is caused by the spirochete Borrelia burkdorferi, transmitted by the ixodid tick. The area of ​​migrating erythema around the tick bite reaches 5-15 cm, sometimes with satellites, it migrates during the febrile period (up to 1 week) and is sometimes accompanied by conjunctivitis, headache, and arthralgia. After 3-12 months, damage to internal organs develops.

Treatment of borreliosis. Children under 8 years old - amoxicillin 50 mg/kg per day, over 8 years old - doxycycline (Unidox Solutab 100 mg 2 times a day) for 10-14 days, if symptoms persist - another 7 days or more. Organ lesions are also treated; in case of severe damage to the heart and central nervous system, ceftriaxone is administered (75-100 mg/kg once a day) for 14-21 days.

Vesicular rash in the form of blisters and blisters filled with fluid, pus or blood.

Chickenpox

The diagnosis of chickenpox is obvious when a characteristic rash appears against the background of a high temperature. Over the course of 2-4 days, the rash evolves sequentially (vesicle-pustule-crust).

Treatment for severe forms of chickenpox: acyclovir intravenously - 40-60 mg/kg per day in 3 infusions. Locally, Sitelium lotion (Aderma medicinal cosmetics) is effective for reducing itching. Prevention: vaccination with live chickenpox vaccine.

Causes of rashes

A red rash in the throat is considered a clear symptom of abnormal processes that occur on the mucous membranes of the respiratory system. Typically, the formation of red dots on the surface of the pharynx rarely indicates complex infectious pathologies. The following factors may cause problems:

• increased air dryness;
• lack of vitamins;
• hypothermia;
• allergy;
• infections;
• ingestion of volatile chemicals into the body;
• decreased body reactivity;
• endocrine pathologies;
• bad habits;
• disorders of the digestive system.

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To determine why red pimples appear in the throat, it is worth studying their location, number and the presence of additional symptoms.

Herpes simplex virus (HSV)

If a person becomes infected with the herpes simplex virus (HSV) for the first time, aphthous stomatitis appears from the 2nd to 3rd day of illness against the background of a very high temperature. Children with atopic dermatitis have a widespread vesiculopustular rash (Kaposi's eczema). Vesicles in the mouth are located in groups and often merge; when they rupture, superficial ulcers with a pale bottom (aphthae) form. The rash continues for 5 days. Due to the soreness of the mucous membrane, children do not eat and drink well. Herpetic stomatitis can be complicated by bacteremia caused by Kingella kingae, with the development of purulent arthritis, osteomyelitis or endocarditis.

Treatment of herpetic stomatitis: acyclovir at a dose of 15-20 mg/kg 5 times a day reduces the duration of virus shedding and speeds up recovery, although it is not necessary with normal immunity. Locally, rinsing with a mixture of a 2% viscous solution of lidocaine, diphenhydramine and maalox is most effective.

Streptococcal sore throat

Streptococcal sore throat is the result of infection with group A streptococcal bacteria. These bacteria cause up to 15% of sore throats in adults and up to 30% in children. A streptococcal infection usually results in a sore throat. Some people may also develop a skin rash.

Other symptoms of pharyngitis may include:

• chills;
• fever;
• headache;
• nausea;
• painful swallowing;
• swollen tonsils with white spots or streaks.

Sore throats are most common in late winter and early spring. Treatment includes antibiotics and painkillers such as ibuprofen or paracetamol. Please note that children under 16 years of age should avoid aspirin due to the possible risk of developing Reye's syndrome. Acute pharyngitis can be treated at home, for this you need:

• peace;
• drink more fluids;
• gargle with salt water.

Viral pemphigus of the mouth and extremities (mouth-hand-foot syndrome)

Viral pemphigus of the mouth and extremities (mouth-hand-foot syndrome) is caused by Coxsackie viruses (serotypes A4-A7, A9, A10, A16, B1-B3, B5) and enterovirus (type 71 and 19). First there is fever, fatigue and sore throat. Then bubbles appear on the mucous membranes of the cheeks, tongue, palate, gums and lips. On the hands and feet, papules turn into small blisters (3-7 mm in diameter), which burst, forming slightly painful erosions. The duration of the disease is 1 week, but the virus is excreted in the feces for several more weeks. For more details, see Fever, stomatitis, blisters on the arms, legs and buttocks - Coxsackie virus.

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Erysipelas is an inflammation of the deep layers of the skin caused by group A beta-hemolytic streptococcus (GABHS). Against the background of high temperature, the skin has redness with clear contours and slightly raised borders. Swelling, tenderness, sometimes lymphangitis. Erysipelas often develops with nephrotic syndrome.

Treatment of erysipelas: intravenous, intramuscular penicillin (100,000 units/kg per day), ampicillin (100-150 mg/kg per day), cefazolin (100 mg/kg per day), josamycin (or other macrolide).

Suppuration of subcutaneous and deep structures is accompanied by high fever and intoxication. Cellulite is an infiltrate of subcutaneous tissue, phlegmon is its suppuration (staphylococci, GABHS or H. influenzae type b). Necrotizing fasciitis of the deep tissues of the extremity is caused by GABHS. Myonecrosis (gas gangrene) - clostridia (C. perfringens, etc.). Characterized by skin hyperemia, swelling, soreness, with phlegmon - fluctuation; with fasciitis - pain and hyperesthesia with a “calm” picture of local changes; with myonecrosis - crepitus.

Treatment is aggressive, with antistaphylococcal drugs (oxacillin, vancomycin) and surgical treatment; for cellulite, fasciitis and myonecrosis - amoxicillin/clavulanate, ceftriaxone, carbapenems, linezolid, as well as clindamycin, metronidazole.

Diagnostics

Differential diagnosis of ulcerous tonsillitis consists of collecting symptoms, ENT examination and testing.

Visual examination is complicated by the similarity of herpangina to other diseases, so it is necessary to carry out mandatory laboratory diagnosis:

• general analysis of urine, feces and blood;
• PCR test of biological fluids to detect the Coxsackie virus;
• serological ELISA test to detect antibodies to pathogenic microorganisms in blood serum.

PCR

The polymerase chain reaction isolates the virus gene in the biological material of the patient.

For diagnosis, take any of the following:

• nasopharyngeal rinses;
• a smear of discharge from the conjunctiva of the eye;
• feces;
• cerebrospinal fluid;
• biopsy material (in case of complications and surgical intervention).

PCR can detect the virus in 95-99% of cases.

Blood tests

A general blood test during inflammatory processes typically determines an increase in ESR and leukocytes. ELISA detects antiviral antibodies (formed from the first day of illness).

Coxsackie markers include immunoglobulins:

• IgM - for the acute period of tonsillitis;
• IgG - in case of a previous illness.

Additional diagnostics

Doctors also carry out additional diagnostics (depending on possible complications of the disease):

• cerebrospinal fluid analysis and MRI of the brain;
• radiography;
• ECG, etc.

Scalded skin syndrome (Ritter's disease in newborns)

The disease is caused by toxins A and B of S. aureus (phagogroup 11, type 71). Bright erythema begins around the mouth, nose, and in parts of the body covered with a diaper; spreading quickly. The skin is very painful and flabby blisters form on it. With the slightest pressure, large areas of skin peel off. The skin looks like it's been burned. Nikolsky's symptom is positive. Healing in 1-2 weeks without scars.

Treatment of scalded skin syndrome: intravenously or intramuscularly: oxacillin - 150 mg/kg per day or cefazolin - 100 mg/kg per day, alternative - vancomycin - 30-40 mg/kg per day, in mild cases - orally cephalexin - 50 mg/day kg per day, for allergies to lactams - clindamycin - 30 mg/kg per day or josamycin 50 mg/kg per day. In newborns, anti-staphylococcal immunoglobulin or plasma is also used. Locally: toilet with 0.1% solution of potassium permanganate, antibacterial ointments.

Urticarial rashes are blisters that are very itchy. The blisters disappear without a trace within a few hours.

Acute urticaria

In acute urticaria, there may be a fever. Urticaria must be differentiated from infectious rashes. Elements of true urticaria persist for no more than a day. The rash persists for more than 24 hours with urticarial vasculitis. This may be a symptom of a systemic disease. The blisters are pale pink. Large blisters have a white center and a reddish rim. The shape of the blisters is oval, ring-shaped, arched, bizarre.

Treatment of allergic urticaria is antihistamines and systemic glucocorticosteroids. Glucocorticosteroids are used only when there is a threat of death - Quincke's edema with laryngeal edema or bronchospasm. For intense itching, you can use hormonal creams and ointments locally.

Prevention

Preventing a sore throat involves supporting your child's immune system. It is also necessary to ensure that the child is dressed appropriately for the weather conditions. A special role is given to the implementation of preventive vaccinations. If the infection spreads, during epidemics it is necessary to reduce the risk of infection of the child by limiting visits to public places.

To prevent sore throat, you must follow several rules:

• strengthen the immune system by consuming enough vitamins and minerals, being in the fresh air, playing sports, and hardening;
• Children should receive the recommended vaccinations for their age to help them develop protection against pathogens.
• If symptoms of a throat infection appear, you should consult a doctor and begin treatment immediately;
• You should avoid the influence of allergens, but if this is impossible, you need to ask your doctor what medications should be used if an allergic reaction develops;
• it is necessary to humidify the air in the living room, regularly remove dust and ventilate the room;
• any foci of chronic infection, for example, a carious tooth or tonsils with tonsillitis, must be treated.

Most often, rashes on the mucous membranes are the result of infection. In this regard, to prevent the appearance of spots and pimples on the mucous membrane, it is advisable to maintain hygiene and promptly seek help from a specialist.

It is important to monitor your diet - a balanced diet and the presence of vitamins and microelements in food will help to avoid vitamin deficiency and related problems.

Erythema multiforme

Provoking factors are herpes, mycoplasma infections, medications (barbiturates, penicillin). Round maculopapular plaques increase in size. 3 zones are distinguishable: the brown center is surrounded by a pink swollen zone, and it is surrounded by a red ring. Unlike urticaria, the elements last a week or more. Lesions of the mucous membranes are not typical. Relapses are possible.

Treatment of erythema multiforme: for HSV infection - acyclovir (doses - see above), against the background of mycoplasma - macrolides, in more severe cases - glucocorticosteroids.

Other causes of the problem

Sometimes, when independently examining the throat, people may notice red blood vessels on the tonsils and palate due to the influenza virus and ARVI. These pathologies are not characterized by specific throat rashes. But petechiae - pinpoint hemorrhages - can form. They often occur against the background of a strong dry cough, which injures the inflamed mucous membrane.

Sometimes the appearance of various red formations in the throat may indicate severe rare diseases:

• typhus;
• Kaposi's sarcoma;
• pyogenic granuloma;
• Kawasaki syndrome, etc.

Erythema nodosum

Against the background of fever, painful bluish ulcerating nodes appear on the legs, less often on the arms, in half of the patients with pain in the joints. They can be a symptom of infection (streptococcal, fungal, mycobacterial, yersinia) or a consequence of the action of sulfonamides, penicillin. Most often, this disease does not become chronic.

Hemorrhagic rash is bleeding into the skin and mucous membranes. Small hemorrhages up to 2 mm are petechiae. Large spots are ecchymoses or bruises. The hemorrhagic rash does not turn pale when pressed (see glass test).

For hemorrhagic rash, the blood test includes the platelet count and prothrombin content. Differential diagnosis: Henoch-Schönlein hemorrhagic vasculitis, idiopathic thrombocytopenic purpura - Werlhof's disease, serum sickness, meningococcemia, hemolytic-uremic syndrome (HUS), Crimean-Congo hemorrhagic fever (CCHF), hemorrhagic fever with renal syndrome (HFRS).

Meningococcemia

A hemorrhagic rash (that does not disappear with pressure) may indicate meningococcemia. At the beginning of the disease, hemorrhages are isolated and small - an antibiotic can stop the further development of the disease. In the absence of treatment, the course is often lightning fast, shock and disseminated intravascular coagulation syndrome with hemorrhage in the adrenal glands develop.

Treatment of meningococcemia: administration (intravenously) of ceftriaxone (100 mg/kg per day), cefotaxime (150 mg/kg per day), ampicillin or penicillin (200 mg/kg per day) + high doses of glucocorticosteroids, anti-shock measures.

Hemorrhagic fever with renal syndrome

Hemorrhagic fever with renal syndrome (HFRS) occurs in the Ural and a number of other regions. HFRS is caused by hantaviruses, their reservoir is rodents. HFRS is a high temperature, red eyes, subcutaneous hemorrhages - petechiae and ecchymoses, bleeding, kidney damage with the development of acute renal failure.

The diagnosis of hemorrhagic fevers is confirmed serologically.

Treatment of hemorrhagic fevers: symptomatic; for CCHF and HFRS, ribavirin is administered (intravenously slowly - 33 mg/kg, then every 6 hours - 16 mg/kg for 4 days).