Abstract
Jakubowski, T.L., Perron, T.J., and Teixeira, E. (2015). Rashes in school: Can they stay, or should they go? NASN School Nurse, 30(5): 274–282. (Original DOI: 10.1177/1942602X15596815)
In the September 2015 issue of NASN School Nurse, the images for Lyme Disease and Spider bites were reversed. The correct order appears below.
Bites/Stings in Children
Diagnosis
Rash Description
Signs and Symptoms
Stay in School or Go Home?
Photo
Transmitted by deer
tickErythema rash when present, “Bull’s eye rash” distinct red borders with
central clearing.
Rash at site of bite but can have multiple
rashesFever, joint pain, malaise, headache, single swollen joint usually knee
usually accompany the rash.
Not Contagious: Can stay at school.
Incubation: 1-32 days median is
11 days.
Prevalence: April through October with more than 50% of the
cases presenting in June and July.
Rickettial infection transmitted by wood ticks.Characteristic spotted rash, maculopapular and sometimes petechial
rash.
Triad of fever, rash, and history of tick exposure, headache, vomiting, sore
throat
Not Contagious: Can stay at school.
Rash initially appears on wrists
and ankles and spreads to trunk within hours. Palms of hands and soles of feet
are also involved.
Incubation: Average time frame one week. Can range
2-14 days.
Prevalence: August through September highest
prevalence.
(Mites)Papules and burrows, excoriation secondary to scratching.
Intense itching especially at night. Commonly seen between the fingers and
toes.
Is Contagious: Should go home.
Skin-to-skin contact. Mites can remain
alive for > 2 days on clothing and bedding.
Incubation: 4-6
weeks
If the child had it previously 1-4 days.
*Can return to
school with medical clearance.
Localized swelling, redness. If allergic can spread rapidly. Raised pink
wheel.
Pain, redness, swelling, hives if allergic, respiratory distress if highly
allergic.
Not Contagious: Can stay at school.
Localized redness, swelling, can spread if infection – cellulitis can
occur.
Pain, redness, swelling. Bites are commonly seen on thighs, buttocks and
abdomen.
Not Contagious: Can stay at school.
(Cimex Lectularius)Red itchy welts that appear in a row. Numerous bites appear as a red itchy
wide spread rash. Often mistaken for mosquito bites.
Red, itchy, swelling
Appear on face neck and extremities, areas
exposed during sleep.Not Contagious: Can stay at school.
Incubation: Bites may not appear
for several days after exposure.
Red spots surrounded by reddened haloes.
Red, itchy.
Commonly seen on the feet and ankles.Not Contagious: Can stay at school.
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