Infections of the skin (fungal infections, acne, impetigo, boils), influenza, conjunctivitis, ear infections (otits externa and media), bronchitis and pneumonia, and infectious diarrheal disease may benefit from vitamin A. Even in children who are not vitamin A deficient, vitamin A can lessen the severity of communicable infectious diseases.5,12,13 For example, vitamin A supplements taken with measles or infectious diarrhea can reduce complications and mortality by more than 50 .5,13
By Staphylococcus aureus (Staph) and Streptococcus (Strep). Strep throat is a common sickness caused by Streptococcus. Some physicians also suggest that children with certain skin conditions such as acne or impetigo (a common skin infection that causes crusty sores) use antibacterial soap to control these conditions.
Prevention of the spread of S. aureus colonization within the nursery is a challenging prospect. Neonatal staphylococcal skin infections include bullous impetigo, sta-phylococcal scalded skin syndrome, and toxic shock syndrome. Staphylococcal pneumonia is associated with significant mortality and is characterized by the formation of microabscesses, which may rupture and lead to empyema, and by the formation of pneumatocoeles because of obstruction of terminal bronchioles. Osteomyelitis is infrequent and manifests differently in neonates than in older children. In neonatal osteomyelitis, the membranous bones (scapula, maxilla) are affected as well as the long bones. In addition, neonates with osteomyelitis may not exhibit fever or laboratory abnormalities suggestive of infection. Staphylococcal endocarditis is rare in neonates.
As disseminated infections with filamentous fungi or mycobacteria are difficult to diagnose in a timely fashion, biopsies and cultures of suspicious skin lesions are often helpful. Pseudomonas, Candida spp., and Fusarium are particularly likely to be associated with skin lesions. Lesions of ecthyma gangrenosum most often reflect disseminated infection with Pseudomonas. Disseminated candidiasis can present with nodular or papular scat
Swelling, redness, and tenderness, although frequently caused by trauma, are not specific signs of injury. Although it is important to record whether these features are present, it must be remembered that there also may be nontraumatic causes for these lesions (e.g., eczema dermatitis or impetigo).
Infants with CCC typically present on the first day of life with a generalized rash consisting of erythematous macules, papules, or pustules on a 5- to 10-mm erythematous base. Generalized erythema can be seen initially, which then can evolve into a severe skin eruption with discrete papules or vesicles and sometimes bullae. The eruption occurs predominantly on the back, extensor surfaces, skin folds, palms, and soles, but the perineum area is spared. The rash in very low birth weight infants can rapidly progress to bullae, erosion, and desquamation resembling burns or scalded skin. This is associated with an extreme leukemoid reaction. The nails may also be involved and appear opaque, raised, and rough. With the loss of the skin barrier, the preterm infant is at risk for dehydration and secondary bacterial infections. The differential includes staphylococcal pustulosis, bullous impetigo, syphilis, neonatal pustular melanosis, toxic epidermolysis bullosa, incontinentia pigmenti,...