27 October 2003
Dear Readers: Sincerely,
Dr. Warren hopes to help all who ask his advice and to enlighten all who read Ask Dr. Warren. For your own well being please keep in mind that
advice you read here may not apply exactly to your own situation, and that if you are sick, no information on the web can take the place of a hands on examination by your physican who knows you and cares about you.
Dr. Warren
-MM
Dear MM: A tender and persistent red ring around the anus may be a skin infection. This can be seen with rectal infections with strep. Have it checked by the pediatrician.
Sincerely,
Dr. Warren
I have been unable to locate any information on this disease on the web. If you have any information on this disease that you can forward to me, I'd appreciate it.
Thanks.
-A
Dear A: Roseola is a virus which causes infections only in infants. Older children and adults are already immune. The virus causes high fever for 3 to 5 days, but does not make the infant very sick. The infection ends with the fever breaking abruptly and the infant developing a rash which may last from a few hours to a day. The diagnosis is made on clinical grounds based on the usual course and therefore can only be made when the illness ends.
Sincerely,
Dr. Warren
-JM
P.S. I am 15 years old and I also have a DD bra size Could that have anything to do with it? I were top of the line support bras.
Dear JM: Even with a good support bra large breasts may affect posture and put a strain on your back muscles. Hip pain may be something unrelated which could require attention. Since your symptoms are persisting, you need to see your doctor.
Sincerely,
Dr. Warren
Again, thank you for your time.
-Bill
Dear Bill: Most viruses are species specific, however some viruses such as rabies can be transferred between species. Worms are not viruses. They are parasites which live part of their life cycle in an animal. Since worms don't live inside cells like viruses, many of them are not species specific, but some are. Most worms live part of their life cycle in the intestinal tract. They pass to the outside world through stool and spread to their next victim by exposure to the excrement. Since their infectious stage (eggs or larvae) are microscopic, exposure could be as simple as getting into your food from your hands. Hookworm enters the body through the skin, and so can be contracted by walking barefoot on ground that has been contaminated by infected excrement.
Careful hand washing and management of your dogs excrement should prevent any worms from spreading from your dog to you.
Sincerely,
Dr. Warren
-F
Dear F: If you wish to see a specialist about persistent diarrhea, the one to see is a gastroenterologist.
Sometimes diarrhea can persist a long time and is not necessarily a cause for concern. If the infant is no longer ill, has a good appetite, and is well hydrated, it may just take time for the intestines to recover. Some children continue to have diarrhea because they are drinking too much juice. Sometimes babies on milk based formulas have to switch temporarily to a lactose free formula.
Sincerely,
Dr. Warren
Thank you for your time.
-DM
Dear DM: It is now more than 24 hours since you wrote to me. Unfortunately, it is not possible for me to answer e-mail on an urgent basis. The management of persistent vomiting requires giving only small amounts of an oral electrolyte rehydration fluid frequently. Pedialyte and Kaolectrolyte are oral electrolyte rehydration solutions. If your daughter has not held down any fluids since you wrote to me, it is time for an urgent visit to the pediatrician to be sure that she is not dehydrated or for appropriate treatment if she is.
Sincerely,
Dr. Warren
-A Concerned Family Member
Dear Concerned Family Member: Since you are describing a complex anomaly, I suspect that I am missing some vital information to know what is really going on with the child. There are times that anomalies don't fit into any known combination of defects and the surgeons must devise an approach to doing a repair. While I can understand your being anxious to get everything corrected as soon as possible, that does not always give the best result. You need to consult a pediatric urologist to determine what the treatment options are, what results can be expected from the surgical repair, and what risks are involved in the proposed treatment. This includes understanding what the treatment options are now and what the risks to the baby are until surgery. It also includes understanding whether or not full kidney function can be expected to return and how sick or healthy the baby can be with her current degree of kidney function.
Sincerely,
Dr. Warren
We are very concerned because we have no answers.
Thank you for any time you may be able to spare.
-PG
Dear PG: You didn't say where on your granddaughter's spine the dimple developed. If it is at the base of the spine, at the top of the crease between the two buttocks, it is a pilonidal dimple. The hole is a pilonidal sinus. Sinus tracts are things that develop during embryogenesis. The complexities of development of a human body from a single cell involves formation of tubular structures and migration of cells. This process sometimes leave sinus tracts. Most sinus tracts never cause any problem and can be left alone. Sometimes they become obstructed and form a cyst. Pilonidal cysts can become infected and cause pain. If that happens, surgical treatment is needed.
If the sinus tract is at another location along the spine, since I am not familiar with any such thing, I'd have to recommend further evaluation.
Sincerely,
Dr. Warren
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