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Dr. Navitsky
Dr. Navitsky, Board Certified Pediatrician
Category: Pediatrics
Satisfied Customers: 1037
Experience:  US Pediatrician licensed in California living abroad.
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my 2 year old son has come out in spots and blisters on his

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my 2 year old son has come out in spots and blisters on his bottom, hands, face, legs, feet, also in his mouth. He is off his food and very irritable, keeps falling about. What could it be?

Jnavits12 :

Hi there I can try to help you.

Jnavits12 :

How long has he been sick for?

Customer:

About 3 days ago he had a temperature. Now he has come out with spots and blisters.

Jnavits12 :

Can you describe the spots a bit? Are they like pimples without much surrounding redness, or pus inside them, on his palms, the soles of his feet, maybe around the legs and buttocks but not all over his body right?

Jnavits12 :

The ulcers in the mouth can be on the tongue, in the back of the throat or on the inside of the gums but don't tend to be on the outside of the mouth like on the lips right?

Customer:

Yeah thats right. Although the ones on his tops of toes look like blisters. He has a couple of spots outside his mouth.

Jnavits12 :

So the chances that this is a common viral infection are high. It is called hand/foot and mouth disease as this is where the spots tend to concentrate. They can also happen in lesser concentration however on the legs, arms or tops of hands and feet.

Jnavits12 :

The virus is coxsackie virus which makes us feel good as we can narrow it down to a few serotypes that cause this distinct clinical picture but really it behaves just like any other virus.

Jnavits12 :

Time course to feeling totally better is about a week to 10 days, but after the first few days the spots in the mouth stop hurting so much as bothering him.

Jnavits12 :

It can be accompanied by other cough/cold symptoms and in most kids high fever at the start.

Customer:

I have just checked on him and it seems like he has a high temp again.

Jnavits12 :

It is very painful in the mouth and this is the key to having a smooth course.....good pain control. I love children's ibuprofen as it has a longer halflife than paracetamol and is an antinflammatory drug as well as antifever.

Jnavits12 :

The fever is to be expected and often is around 38-39 degrees.

Jnavits12 :

Cold liquids, smooth slimy things to swallow like yogurt, ice cream, popcicles are good to take as they anestisize the mouth and also act as an antiinflammatory.

Jnavits12 :

He needs to drink but doesn't have to eat a thing. If he doesn't eat he needs an electrolyte solution for kids like Pedialyte or Gatorade if he prefers is OK to make sure he doesn't get dehydrated.

Jnavits12 :

What do you mean by falling about?

Customer:

Ok thank you, XXXXX XXXXX worth making an appointment to see my GP? Or should I just give him the ibuprofen? He has been a bit clumbsy the last couple of days. The first thing that I did when I saw spots was to check them with a glass.

Jnavits12 :

Clumsy like he is dragging and not feeling well and whiny or actually falling when walking? Maybe his muscles hurt (myalgias) generalized muscle aches? His mental status is fine right he knows who he is and who you are and that he is sick etc...

Jnavits12 :

This virus is so classic that if you feel comfortable watching him at home it is OK. Like any other virus he can get a secondary viral infection. Use your parental instincts that I love to rely on. If you can't sleep even after talking to me take him in. If you feel the fever lasts many days and he is not taking much liquids at all take him in. There is some numbing medicine that uses liquid lidocaine that sometimes we use but it is hard to use in a 2 yr old as they really have to cooperate.

Jnavits12 :

Sorry I meant to say secondary bacterial infection like ears, pneumonia, etc..

Customer:

Oh yes he knows who we are etc, no problems like that. Is it congatious? As I have a 6 year old as well.

Jnavits12 :

But of course it is contagious! However most kids get it when they are younger than 6. They may just have cold symptoms and not the mouth ulcers or spots. Your 6 year old as he may have seen this virus before may just get a cold without the mouth ulcers/fever. If you are unlucky he can get the same but his chances are less! I'll cross my fingers for you! If you feel that this chat has been helpful please accept. I'll stay on for a few more minutes if you have other thoughts or doubts. I hope your son feels better soon!

Customer:

Thank you for all your advice, it has been very helpful and has put my mind at rest.

Jnavits12 :

You are very welcome!

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