Baton Rouge pediatrician Archives - Baton Rouge Family Fun

Multi-system Inflammatory Syndrome in Children – Dr. Mindy Calandro

May 31, 2020 by Dr. Mindy Calandro

Until recently, the headlines about Covid-19 have largely been about the disease in adults, especially the elderly and those people with underlying health conditions. As a pediatrician, I’m used to seeing virus like influenza and Respiratory Syncytial Virus (RSV) wreak absolute havoc in children. So, it has been an unexpected, albeit very welcome, “surprise” that Covid-19 seems to be having very little effect on children. However, over the past few weeks, it seems that doctors around the globe are noting cases of children who are being diagnosed with severe inflammation throughout their body – something the Center for Disease Control is now calling Multi-system Inflammatory Syndrome in Children or MIS-C for short. The headlines about this new development in kids are frightening, so let’s talk about what MIS-C really is and how worried parents need to be (keep reading for the good news here).

Multi-system Inflammatory Syndrome in Children

Doctors really like to follow trends or clusters of illnesses, so when doctors in New York City started to see an increase in cases of children with overwhelming inflammation presenting to the hospital, it certainly was noteworthy. Symptoms of children presenting with MIS-C have been varied but include high unrelenting fever, abdominal pain, diarrhea, rash, red eyes, and neck pain. These children are showing massive amounts of inflammation in their blood vessels causing problems in organs such as the heart, kidney, gastrointestinal tract, and brain.

Covid-19

Some of the children who have been diagnosed with MIS-C have been found to have positive antibody tests to Covid-19 without a prior diagnosis of a Covid-19 infection. This would signal that MIS-C would have occurred weeks after a Covid-19 infection (again most likely an asymptomatic infection). It is important to note, however, that there have also been children diagnosed with MIS-C who have had all negative testing to Covid-19. The bottom line right now is that we are not sure what is causing MIS-C.

Kawasaki Disease

MIS-C “Multi-system Inflammatory Syndrome in Children” is closely resembling two other rare illnesses that we see in children…one called Kawasaki disease and one called Toxic Shock Syndrome. The cause of Kawasaki disease is not truly known, but doctors have long suspected that it is likely a post-viral illness where the body’s immune system starts to almost attack itself, leading to inflammation of blood vessels in different areas of the body including the heart. Children with Kawasaki disease present with high fever for more than 5 days, rash, redness to the eyes, changes to their lips or tongue as well as swelling of the extremities and swollen lymph nodes.

Kawasaki disease can be treated, and the majority of children recover from this illness without long term effects (although in some cases, long-term damage to the coronary arteries can occur). Toxic shock syndrome, on the other hand, is caused by bacteria (either Staph or Strep) and can be life-threatening very quickly as it causes extremely low blood pressure, also known as shock.

When the initial cases of MIS-C were seen, children seemed to be presenting with some of the physical signs of Kawasaki disease but with the low blood pressure seen in Toxic Shock Syndrome. As more information is collected, it also seems that children with MIS-C are older with the most common ages being 5 and up. Kawasaki disease, on the other hand, is more commonly seen under the age of 5 (although both of these illnesses can be seen in anyone under the age of 18).

As with a lot of things in medicine right now, we are trying to learn as quickly as we can about the disease process of MIS-C, and work is ongoing to determine whether there is a direct link to Covid-19, whether some children more likely to get MIS-C than others, and whether there is any way to prevent MIS-C from happening.

The Good News for Parents

So, you might be wondering: what about the good news I mentioned above? Well, while the headlines are scary about MIS-C, the most important thing I want parents to take away from this is that MIS-C is still EXTREMELY RARE. While data collection is continuing on a daily basis, as of this writing, 23 states are reporting cases of MIS-C, there are around 250 cases across the US (with close to 100 of those cases being in New York alone), but at the moment, there have been less than 5 deaths nationwide. Just to be clear, while any child dying is absolutely tragic, do keep in mind for reference that influenza has already killed 176 children so far this year.

When it comes to Multi-system Inflammatory Syndrome in Children, doctors and parents alike need to be aware of this new illness and be on the lookout for concerning symptoms. But once again, there is no need to panic as this illness, while scary given its symptoms and complications, remains exceedingly rare. Doctors and scientists are feverishly working to try and learn as much as possible about MIS-C, and its causes, relationship to Covid-19 and, of course, treatment and a cure.

In the meantime, I encourage parents that may be worried about MIS-C to speak with their pediatrician, and if you are worried about your child being ill with any kind of symptoms, please do not be afraid to bring them to the doctor. Pediatricians are available and equipped to see children both healthy and sick during these uncertain times of Covid-19.

“Ask the Experts” is a series on Baton Rouge Family Fun where local experts share their thoughts, opinions and answer questions relating to health, wellness, parenting and living in Baton Rouge.

Disclaimer: The purpose of this site is to share experiences with food, fitness, health, and life as well as opinions from some of our local experts. This content is for informational purposes only and isn’t a substitute for professional medical advice. When it comes to your health or the health of your child, please be sure to contact your physician.

Rapid Urgent Care Now Open and Serving Baton Rouge

March 15, 2017 by Baton Rouge Family Fun

We’ve all been their, it usually happens at the worst possible time… a sports injury, flu, asthma, a fever that just won’t break and always before or after our pediatrician’s office hours. Do you go to the ER or will urgent care suffice? The ER costs an average of three times more than a visit to the urgent care. In a non-life threatening situation, you can most likely be treated at an urgent care facility. The options for care in the Baton Rouge area have grown by leaps and bounds, giving families the choice to stay closer to home or bypass the emergency room when illness or a non-life threatening situation presents itself.

When you or your child need to feel better, faster, Rapid Urgent Care Essen Lane‘s outstanding physicians stand ready to assess, diagnose, and treat your urgent care needs every single day of the year, including holidays. Located on Essen Lane across from Our Lady of the Lake Regional Medical Center and Walgreens.

Some common conditions treated at Rapid Urgent Care Essen Lane

X-Ray and Lab services
Asthma
Bite or sting
Bronchitis
Colds
Coughing
Earache or ear infection
Fever
Flu and flu-like illnesses
Fractures
Hay fever
Minor trauma
Rashes
Skin rash
Sinusitis.
Stomachache
Strep Throat
Sprains

The Baton Rouge location of Rapid Urgent Care is in network with most major insurance carriers including Blue Cross Blue Shield, Aetna, CIgna, United Healthcare, Humana, Gilsbar and People’s Health. They will also accept Medicare,Tricare, Medicaid, and the Amerigroup insurance programs at this location.

If you’re looking for high quality medical care that fits your schedule, Rapid Urgent Care Essen Lane is the place for you. There’s no need to make an appointment to see one of their excellent physicians. Just walk-in. In Baton Rouge, they are open from 7 am to 8 pm every Monday through Friday, and every Saturday and Sunday from 8 am to 4 pm.

Take a peek inside Rapid Urgent Care on Essen Lane
—> http://bit.ly/RapidUrgentCareTour
—> http://www.rapidurgentcare.com/batonrouge

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Hand, Foot, and Mouth Disease

October 13, 2016 by Dr. Mindy Calandro

You know the feeling. The sign posted on the door of daycare announcing the current illness that is floating around. Oh the dreaded sign! “We want to inform you that cases of hand, foot, and mouth disease have been diagnosed here at the center.” GREAT! There are likely two questions that are running through your head: 1) So what are we going to do when our child comes down with this latest illness? and 2) What exactly is Hand, Foot and Mouth disease? Well, that first question is one that I have struggled with many times in my own household, and unfortunately, I can’t help you answer, but that second question…I CAN help with that one!

Hand, Foot, and Mouth Disease

Hand, foot and mouth (HFM) disease is a very common viral illness in children, particularly those under 5 years of age. Older children, teens and even adults can get Hand, Foot, and Mouth Disease, but it is much less common as most people have had HFM by that time and therefore have natural immunity to these viruses. This illness is typically seen in the late summer to fall, but especially here in Louisiana with our mild climate, I will see cases of HFM year round. The virus is spread through contact with droplets of someone who is infected, so it is spread by sneezing and coughing as well as the saliva that children “share” with each other on toys. It is not uncommon to see mini “epidemics” of HFM that spread through daycare centers or other child care facilities. The incubation period for HFM is 3-6 days, so I generally tell parents to be on the lookout for signs of HFM for about 1 week after “the sign” is posted at daycare.

What are the symptoms of Hand, Foot, and Mouth Disease

As with any other virus, each child may present differently, but most children will start out with fever. In the next few days, children will often develop the classic rash that really can be anywhere on the body but, as the name suggests, most commonly is seen on the hands, feet, and around and in the mouth. The rash looks like small blisters or ant bites, and you will find these spots on the palms and soles of the feet (there are not a lot of illnesses that will cause a rash on the palms and soles but HFM is one of them).

Especially in infants and toddlers, I will almost always see the rash in the diaper area and on the backs of the thighs as well. If you look inside the mouth, you may see ulcers on the inside of the lips or tongue as well as in the back of the throat. These blister lesions will typically continue to pop up over the first 3-5 days of the illness. After that time the rash will slowly begin to fade, and parents may even notice peeling of the skin where the blisters were located in the coming week. Finally, some children will have changes to their fingernails or toenails about 4-6 weeks after hand, foot, and mouth disease, and it may appear like the nail is “splitting” horizontally and coming off. No worries…there is a new nail under there!

Since HMF is caused by a virus, antibiotics will not make the illness or the rash go away. The mainstay of care for HFM is making sure children are drinking lots of liquids and using acetaminophen or ibuprofen to help with fever. Sometimes the throat can be so painful for children that they will not want to drink liquids, and then the concern is that they could be become dehydrated. When it comes to liquids to offer, I often say that when kiddos are sick, they can have free reign of the liquids…so that means juice, milk, popsicles, Slurpees or even ice cream. Just something that has liquid form to it! If your child is refusing to take liquids, make sure and call your pediatrician as there are some occasions where a special mouthwash can be used to help with the pain. As far as the rash goes, most children are not bothered by the rash. It doesn’t hurt or itch typically and may only cause mild discomfort when walking for those children that have their little feet covered in blisters.

Now for the last remaining question that every parent asks, “When can my child go back to daycare/school?” and the answer might surprise you. Once your child is fever free for 24 hours and tolerating liquids well, they can return to school. Unlike chicken pox, the hand, foot, and mouth disease rash itself is not contagious! The only time I would recommend keeping kids out of daycare in regards to the rash is if they have many open sores that they are itching as these could easily become superinfected with bacteria (this is not very common with HFM whereas with chicken pox, superinfections of the skin are much more common). The virus that causes hand, foot, and mouth disease can be shed through respiratory droplets for 1 week after the illness and can be shed in the stool for several weeks following symptoms, so by no means are children kept out of daycare or school for this period of time. This is again one of those times where you hope your daycare is doing a good job of wiping down toys, washing hands, and practicing very good diaper changing hygiene!

For those of you who have been “lucky” enough to experience Hand, Foot, and Mouth Disease already, you may say, “Wait a minute! My daycare told me that she couldn’t return until the blisters were crusted/gone.” Well, as I said above, fever free for 24 hours is the main criteria for return to daycare or school, but child care facilities are able to set their own return policies when it comes to infectious diseases like hand, foot, and mouth disease, so in many cases, their policy will be the “law of the land.”

So if the next dreaded sign on the door at daycare reads “Hand, foot and mouth disease,” take a deep breath as you are now armed and ready to deal with this unpleasant but all too common illness of childhood. And as with any illness, if you have specific questions or concerns about your child, please make sure and give your pediatrician a call…it’s what we are here for!

“Ask the Experts” is a series on Baton Rouge Moms where local experts share their thoughts, opinions and answer questions relating to health, wellness, parenting and living in Baton Rouge.

Disclaimer: The purpose of this site is to share BRM moms’ experiences with food, fitness, health and life as well as opinions from some of our local experts. This content is for informational purposes only and isn’t a substitute for professional medical advice. When it comes to your health or the health of your child, please be sure to contact your physician.