Appendicitis is a medical emergency that must be treated surgically; it cannot be treated at home. A child with a suspected case of appendicitis should see a doctor immediately. since the doctor will need to examine the child's abdomen for signs of pain and tenderness, no pain medication should be given without a doctor's permission. if there is a suspicion of appendicitis, no food or liquids should be given as possible preparation for surgery.

The decision whether to operate or not is most often based on history and physical exam. surgeons have the option of removing a child's appendix either through the traditional abdominal incision, or by using a small surgical device called a laparoscope to create a smaller opening in the abdomen. However, if the appendix has perforated, surgery becomes more complex and the risk of complications increases.

if the appendix is removed surgically before it perforates, complications are rare. After the surgery the child usually must remain in the hospital between one and three days. Even if the appendix has not perforated, the doctor may prescribe antibiotics to decrease the risk for wound infection after surgery.

However, if the infected appendix perforates, a longer hospital stay is needed.


There is no way to prevent appendicitis. Although appendicitis is rare in countries where people eat a high-fiber diet, experts have not yet proven that a high-fiber diet definitely prevents appendicitis.

arboviral infections Infections caused by any of a number of viruses transmitted by arthropods such as mosquitoes and ticks, such as west nile virus, encephalitis, eastern equine encephalomyelitis, St. Louis encephalitis, and California encephalitis. The term arboviral is short for arthropod-borne. These types of infections usually occur during warm weather months when mosquitoes are active.

Children are especially susceptible to getting an arboviral infection. Most of these type of infections are spread by infected mosquitoes, but only a few types of mosquitoes are capable of transmitting dis-ease—and only a few of these actually carry a virus. Infection with one arbovirus can provide immunity to that specific virus and may also protect against other related viruses.


Symptoms of the different types of arboviruses are usually similar, although they differ in severity. Most infections do not cause any symptoms at all; mild cases may involve a slight fever or headache. Severe infections quickly cause a severe headache, high fever, disorientation, coma, tremor, convulsions, paralysis, or death. Symptoms usually occur between five and 15 days after exposure.


Because there are no specific treatments for these kinds of viral infections, treatment is typically aimed at relieving symptoms.


The arboviral diseases can be prevented by using insect repellents when outdoors in mosquito-infested areas, using screening, and community control programs.

arthritis A group of more than 100 different diseases that is considered to be one category of rheumatic diseases. Rheumatic diseases may cause pain, stiffness, and swelling in the joints and other supporting body structures, such as muscles, tendons, ligaments, and bones. However, rheumatic diseases also can affect other areas of the body, including internal organs. When the immune system does not function properly, it leaves the body susceptible to an array of diseases, including juvenile rheumatoid arthritis.

Arthritis and rheumatic disease can affect anyone, at any age, or of any race. There are nearly 300,000 children in America with some form of arthritis or rheumatic disease. Juvenile rheumatoid arthritis affects children between two and 16 years of age more frequently. Septic arthritis is diagnosed in 6.5 percent of all pediatric arthritis cases and occurs at a slightly higher rate in boys.

The impact of arthritis on school, social life, family relationships, dating, sports, and almost every other aspect of an active, growing child's life raises special concerns. New coping skills for living with the everyday challenges of arthritis must be learned.


Pain and stiffness over a joint is the primary symptom. Many children experience a period of stiffness when they get up each day. This morning stiffness can be one of the best measures of disease activity; the longer the stiffness lasts, the more active the disease. Taking a hot bath or shower, sleeping in a sleeping bag or water bed, doing range-of-motion exercises, or using a hot or cold pack can help relieve pain. Although most children do better with warmth, there are a few who respond to cold.


The cause of most types of arthritis remains unknown and, in many cases, varies depending on the type of disease present. However, researchers believe that some or all of the following may play a role in the development or aggravation of one or more types of rheumatic diseases:

• genetics and family history (i.e., inherited cartilage weakness)

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