Leukopenia and thrombocytopenia (≤100,000 cells/mm3) are common. Between days 3 and 7 of the illness, the clinician must watch for signs of vascular leakage. Hemorrhagic manifestations may be observed in the febrile and/or critical phases. The range and severity of hemorrhagic manifestations are variable. Major skin and/or mucosal bleeding (gastrointestinal or vaginal) may occur in adults with no obvious precipitating factors and only minor plasma leakage. In children, clinically significant bleeding rarely occurs, and when it does, it is usually associated with profound and prolonged shock. Two Cuban studies noted spontaneous petechiae or ecchymoses in approximately half of the patients studied (Thomas et al., 2022). Self-Assessment Quiz Question #5 Which of the following statements about dengue fever is true regarding the rash? a. The rash appears in all cases of dengue fever. b. The rash typically appears on the palms of the hands and soles of the feet. c. The rash is always itchy and painful. d. The rash appears on the fifth day of illness and lasts for several days. recommended time before it is washed off. Clean clothes should be worn after treatment. In addition to the infested person, the treatment is recommended for household members and sexual contacts, particularly those who have had prolonged skin-to-skin contact with the infected person. All persons should be treated at the same time in order to prevent reinfestation. Retreatment may be necessary if itching continues more than 2 to 4 weeks after treatment or if new burrows or rashes continue to appear (CDC, 2018). Figure 10. Scabies
Figure 9. Dengue Rash
From Premaratna, R. (2012). Dengue recovery rash https://commons. wikimedia.org/wiki/File:Shingles_on_the_chest.jpg CC BY-SA 3.0 Scabies Human scabies is caused by an infestation of the skin by the human itch mite ( Sarcoptes scabie i var. hominis ). The microscopic scabies mite burrows into the upper layer of the skin, where it lives and lays its eggs. The most common symptoms of scabies are intense itching and a pimple-like skin rash. The scabies mite is usually spread by direct, prolonged, skin-to-skin contact with someone with scabies. Scabies occurs worldwide and affects people of all races and social classes. Scabies can spread rapidly under crowded conditions where close body contact is frequent (CDC, 2018). Institutions such as nursing homes, extended-care facilities, homeless shelters, and prisons are often sites of scabies outbreaks. The most common signs and symptoms of scabies are intense itching (pruritus), especially at night, and a pimple-like (papular) itchy rash. The itching and rash may affect much of the body or be limited to common sites such as the wrist, elbow, armpit, webbing between the fingers, nipple, penis, waist, belt line, and buttocks. The rash also can include tiny blisters (vesicles) and scales. Scratching the rash can cause skin sores, and these sores sometimes become infected by bacteria. Tiny burrows are sometimes seen on the skin. They are caused by the female scabies mite tunneling beneath the skin’s surface. These burrows appear as tiny, raised, crooked (serpiginous) grayish-white or skin-colored lines on the skin surface. Because there are often only a few mites (only 10 to 15 mites per person), these burrows may be difficult to find. They are often found in the webbing between the fingers; skin folds on the wrist, elbow, or knee; and on the penis, breast, or shoulder blades. The head, face, neck, palms of the hands, and soles of the feet are often involved in infants and young children but usually not in adults and older children (CDC, 2018). Products used to treat scabies are called scabicides because they kill scabies mites; some also kill eggs. Scabicides to treat human scabies are available only with a doctor’s prescription; no over-the-counter (nonprescription) products have been tested and approved for humans. Permethrin cream 5% (Elimite) is the treatment of choice. When treating adults and older children, scabicide cream or lotion is applied to all areas of the body, from the neck down to the feet and toes; when treating infants and young children, the cream or lotion is applied to the head and neck. The medication should be left on the body for the
From Miller. J. (1976). 15382. https://phil.cdc.gov/Details. aspx?pid=15382. In public domain
Self-Assessment Quiz Question #6 Which of the following is an effective management strategy for scabies? a. Taking a cold shower and applying moisturizer. b. Washing clothes, bedding, and towels in hot water and drying them on high heat. c. Using a topical cream that contains corticosteroids. d. Applying tea tree oil directly on the affected area.
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Book Code: AUS3024
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