GP Notes

Child presents with symptoms consistent with hand, foot and mouth disease - fevers - runny nose - reduced oral intake - raised lesions on hands, feet and mouth Examination: temp: Ear Nose and Throat exam: - Ear:  No redness or discharge - Clear rhinorrhoea - No pharyngitis.  tonsils are not enlarged, not inflamed and have no pus Cervical lymphadenopathy present Respiratory exam was normal - No respiratory distress - Bilateral air entry - No crepitations or wheeze heard on auscutation Nil signs of meningitis: - Nil photophobia - nil purpuric rash - Nil neck stiffness Red maculules on the hands and feet Shallow ulcers in the mouth Reason for visit: Hand, foot and mouth disease Management: Parents reassured and the diagnosis explained Regular paracetamol +/- Ibuprofen Careful hygeine Advised to exclude child from daycare / school until blisters have dried up Return here or to ED if not improving or concerns they are getting worse Actions...

Patient presents with red lesions On Examination: Vesicopustular lesions with honey-coloured crusts Management of Impetigo advised to patient: 1. Soak a clean cloth in a mixture of half a cup of vinegar and 1 Litre of tepid water.  Apply the compress to moist areas for 10 minutes several times a day then wipe off crusts 2. Bactroban 3 times a day for 10 days 3. Other general measures: - Cover the sores - Avoid close contact with others - Regular hand washing - Use separate towels and cloths - change and launder clothes and linen daily Oral antibiotics as prescribed (Fluclox 12.5mg/kg qid for 10 days or Cephalexin 25mg/kg bd for 10 days) Exclude from childcare until antibiotics have commenced and any sores on exposed skin should be covered with a watertight dressing Keywords:  Impetigo , School sore, +impetigo