The child has a fever and a rash

The symptoms of fever are not the same for every child, and different treatment methods will be chosen according to the different causes of the child's illness. Many children will feel some swollen symptoms in their bodies after having a fever. Sometimes many children have a fever caused by bacterial infection, so it is necessary to start anti-bacterial drug treatment first.

1. Staphylococcus aureus sepsis: There is a primary skin infection (such as squeezing a boil and incising an immature abscess), followed by symptoms of septicemia and migratory lesions of the rash. This disease is very likely to be the cause. If no infection focus is found or the symptoms are mainly damage to a certain organ, diagnosis is difficult. Timely blood culture and bone marrow culture can confirm the diagnosis. In the past, it was believed that coagulase positivity was the basis for judging the pathogenicity of Staphylococci, and blood culture positive for Staphylococcus epidermidis (coagulase negative) was mostly contamination.

In recent years, it has been reported that this bacterium can cause nosocomial infections (such as wound infections, catheter infections and sepsis) in immunocompromised patients. The conditions for considering this disease are: blood culture must be positive for more than 2 times; the biotype of the isolated Staphylococcus epidermidis is similar to the antibiotic type; the clinical symptoms improve after treatment with appropriate antibiotics

2. Escherichia coli sepsis: common in hepatobiliary tract, urogenital tract, gastrointestinal tract infections, cirrhosis, abdominal surgery, urethral surgery (including catheterization), characterized by bimodal fever, high fever with relatively slow pulse, early onset of shock (about 1/4-1/2 patients) and long duration. Most white blood cell counts are increased, while a few may be normal or decreased (but neutrophil count is high). Migratory lesions are rare

3. Anaerobic sepsis: The main pathogens are Bacillaceae, followed by anaerobic Streptococcus, Clostridium perfringens, etc. Anaerobic bacteria are often mixed with aerobic bacteria. The characteristics are a high incidence of jaundice (10%-40%), which may be related to the direct damage of the liver by its endotoxins, and/or the hemolytic effect of the toxin a of Clostridium perfringens; gas formation in local or migratory lesions (most prominent in Clostridium perfringens); secretions with a special putrid odor; causing septic thrombophlebitis with abscesses in the abdominal cavity, lung thoracic cavity, brain, endocardial bones and joints; hemolytic anemia and renal failure may occur.

4. Fungal sepsis: Common ones include Candida albicans (the majority), Aspergillus, Mucor, etc. It usually occurs during the long-term use of corticosteroids or broad-spectrum antibiotics in the later stages of an existing serious illness. The clinical manifestations are milder than those of bacterial sepsis. The absence of fever or low fever is often due to the symptoms of the primary disease that masks the slower progression. Blood culture can detect pathogenic fungi, and culture of pharyngeal swabs, sputum, feces, urine, etc. can obtain the same fungus growth

5. Rare sepsis: Moraxella sepsis is common in immunocompromised children under 6 years old. The key to diagnosis is the identification of Moraxella. Acinetobacter sepsis is more common in the elderly and infants, especially those with diabetes and cancer, who are most susceptible to nosocomial infection. The main sources of infection are the intravenous cannula of the ventilator and the hands of medical staff. Purple bacillus sepsis, the causative bacteria are Gram-negative bacteria, which are the only bacteria that produce purple pigment. It can enter the body through broken skin, gastrointestinal tract and respiratory tract. Local lymphadenitis and cellulitis may develop rapidly into sepsis, which may be accompanied by migratory abscesses. The diagnosis is mainly based on bacteriological examination.