How do I know when it's just the sniffles or a real bad cold? How do I know when the fever is just from teething or the baby has an infection? Should you panic when your child doesn't eat one of his meals or is it just a toddler thing? These are just some of the questions that parents with children with HIV face everyday. Most parents don't want to miss something but they don't want to be running to their provider or emergency room constantly.
This is a guide that has helped many of the parents here in our program with just those same concerns about signs of infection. Hopefully you will find it useful also.
- Fever: A temperature of 101° F or above that lasts at least 24 hours usually indicates some kind of infection that needs follow-up with a doctor or a nurse. You can use acetominophen (Tylenol) or ibuprophen (Motrin) and this may bring it down but if the next day there is a fever see your nurse or doctor. However if the baby is less than 3 months old and has a fever call your nurse or doctor for advice. They may want to see the baby sooner.
- Vomiting: If your child is an infant and is vomiting after every feeding (a large amount, not just spit up) or has vomited more than 4-5 times in one day you need to call your nurse or doctor. It may be a simple virus, but since infants can get dehydrated (dry) so quickly, it's better to check. If your child is older and is vomiting, call your nurse or doctor. Depending on your report to them, many times things can be done at home and your child will not have to be seen.
- Diarrhea: Diarrhea is loose watery usually green stool (bowel movements) occurring 4-5 times a day. It can also be mucousy, loose and occurring at least 4-5 times a day. It is not just one loose stool. If your child is an infant you should call your nurse or doctor to avoid dehydration. Most of the time you will be asked to bring in a stool specimen, so bring in one of the diapers. If there is any visible blood, bring that to the attention of your nurse or doctor immediately. If your child is older and having loose, watery, or mucousy stools more than 4-5 times a day and their activity is unchanged call your nurse or doctor. Depending on your report, many things can be done at home, and your child will not have to be seen. However, they will probably still want a stool sample, especially if the diarrhea lasts more than one day.
- Appetite: Changes in appetite, such as eating or drinking less, difficulty swallowing or drooling lasting more than one day may indicate thrush (white patches in mouth) or herpes (usually redness in the mouth) and needs a call to your nurse or doctor because your child will need to start medication to clear up the infection. If your child is not feeling better in 24-48 hours then you will need to go see your nurse or doctor.
- Rashes: Bumps, lumps, or any sores on the skin need to be reported and seen by your nurse or doctor. Medications cannot be given over the phone; all skin lesions need to be seen. Always call ahead so the clinic can make arrangements to see your child and at the same time protect the other children at the clinic.
- Coughing: Chest congestion, difficult or painful breathing need to be reported to your nurse or doctor immediately. Any signs that your child is having problems breathing -- for example, using their stomach to breathe, moving their nostrils when breathing, or needing to sit up to breathe -- needs immediate attention.
- Nosebleeds: Nosebleeds that take at least 5 minutes to stop, more bruising than usual or bruising without a known cause needs a call to your nurse or doctor. Most of the time you will need to come in for blood tests and if the child needs any medicine this can be done in the clinic.
- Changes: Changes in behavior, difficulty walking, doing usual activities, dizziness, shaking of extremities (hands or feet) need a call to your nurse or doctor immediately. These changes may mean that there is a problem in the brain. Your child will need to be examined and may need special tests that only your nurse or doctor can arrange.
Remember that exposure to any communicable disease such as chicken pox, measles or tuberculosis must be reported immediately to your nurse or doctor to protect your child.