Fungal infections of the scalp, skin or nails

Children can be infected with ringworm directly from a person, a pet or the environment.

Hats, clothing, combs, carpets, and participation in contact sports can all result in infection.

Many fungal infections require 1 to 2 months of treatment

By SickKids staff

Learn about different types of fungal infections, the causes, and the signs and symptoms to look for.

Key points

• Athlete's foot is common in teens.
• Fungal infections of the scalp and skin are common in children.
• Nail fungus is rare in children.
• The type of medication prescribed and length of treatment will depend on the location of the fungal infection.

Introduction

What is a fungal infection?

Fungi are organisms like mushrooms, molds and yeasts. As parasites, they live on or in other plants or animals. Some fungi live on humans and cause skin disease. Some fungal infections are called tinea or ringworm.

Here are some common types of fungal infections:

• Body ringworm is a fungal infection on the body.
• Scalp ringworm is a fungal infection of the scalp. It occurs most commonly in young children.
• Athlete's foot is a fungal infection of the foot. It is more common in teens and older people.
• Nail fungus, or onychomycosis, is rare in children.

See tinea versicolor and oral thrush for more information on some other fungal conditions.

Signs and symptoms

Signs and symptoms of a fungal infection

Body ringworm (tinea corporis)

• solitary circular or oval flaky patch with raised, mildly reddened borders
• itchiness
• can become very inflamed in some individuals (kerion)

Scalp ringworm (tinea capitis)

• one or more patches of hair loss
• black dots on the scalp
• scaly and itchy
• short broken hairs
• raised tender inflamed area in some individuals (kerion)

Athlete's foot (tinea pedis)

• cracked skin between toes
• itchy or burning
• the sole of the foot may become involved

Fungal nail infections (onychomycosis)

• rare in children
• usually occurs after an injury to the nail
• nails may become thick and discoloured

Causes, risk factors and prevalence

Causes of fungal infections

Fungal infections happen when fungi attack the outer layer of skin on the scalp or body in areas that are warm and moist.

Children can be infected with ringworm directly from a person, a pet or the environment. Hats, combs, clothing or household items such as carpets as well as participation in contact sports can all result in infection.

Sweaty feet or wearing wet socks and tight shoes can lead to athlete's foot in adolescents. It can also occur after walking barefoot on floors of locker rooms and showers at community pools and gyms.

Diagnosis

Diagnosing a fungal infection

Your child’s health-care provider will examine your child. Some fungal infections are diagnosed based on their typical appearance while others are confirmed after a small sample, or scraping of the skin or nail is sent to a lab to look for the presence of fungi.

Treatment

Treating a fungal infection

For a fungal infection affecting the body, feet or face, your child's health-care provider will recommend or prescribe an antifungal cream. If the infection is widespread or if the scalp is affected, your child will need to take an antifungal medication by mouth to treat the infection. Many fungal infections require 1 to 2 months of treatment.

For athlete's foot, specialized sprays, powders and creams are available at your pharmacy. The most effective topical agents are terbinafine, azoles and ciclopirox.

Prevention

Preventing fungal infections

Fungal infections can spread by direct person-to-person contact. Encourage your child to stay away from infected people or pets and to wear dry socks and shoes in public spaces and flip-flops in communal showers and locker rooms. Have your pets examined if fungal infections are suspected. Discourage your child from sharing personal items such as combs or hats with friends.

Last updated: February 1st 2024

 

 

Αυτές οι πληροφορίες προορίζονται για γενική ενημέρωση του κοινού και σε καμία περίπτωση δεν μπορούν να αντικαταστήσουν την συμβουλή ιατρού ή άλλου αρμόδιου επαγγελματία υγείας .

This information is intended as a general guide only and not to provide specific information for individual patient care. Any questions about your own situation should be directed to your medical practitioner.

 

A Guide to Safety for Young Athletes

For young athletes, sports activities are more than play. Participation in athletics improves physical fitness, coordination, and self-discipline, and gives children valuable opportunities to learn teamwork.

Because young athletes are still growing, they are at a greater risk for injury than adults. The consequences of overdoing a sport can include injuries that impair growth and may lead to long-term health problems.

Fortunately, many youth sports injuries can be prevented. Some of the more effective ways to prevent these injuries include:

• Age-specific coaching
• Appropriate physical conditioning
• Proper use of equipment

In addition, coaches and parents can prevent injuries by fostering an atmosphere of healthy competition that emphasizes confidence, cooperation, and a positive self-image, rather than just winning.

Differences Between Child and Adult Athletes

Children Are Still Growing

The young athlete is not a smaller version of an adult. Children's bones, muscles, tendons, and ligaments are still growing, making them more susceptible to injury. In addition, there are significant differences in coordination, strength, and stamina between children and adults.

Children Vary in Size and Maturity

Young athletes of the same age can differ greatly in size and physical maturity.

• Grade school students are less likely to experience severe injuries during athletic activities because they are smaller and slower than older athletes.
• High school athletes, however, are bigger, faster, stronger, and capable of delivering tremendous forces in contact sports.

Children Can Injure Growth Plates

Growth plates are the areas of developing cartilage at the ends of long bones where bone growth occurs in children. The growth plates are weaker than the nearby ligaments and tendons. A twisted ankle that might result in a sprain in an adult, could result in a more serious growth plate fracture in a young athlete. Growth plate injuries have the potential to disrupt the normal growth of bone.

Common Youth Sports Injuries

Acute Injuries

Acute sports injuries are caused by a sudden trauma, such as a twist, fall, or collision. Common acute injuries include:

• Broken bones
• Sprains (ligament injuries)
• Strains (muscle and tendon injuries)
• Cuts or bruises

Most acute injuries should be evaluated by a doctor. Prompt first aid treatment should be provided by coaches and parents when the injury occurs. This usually consists of the RICE method:

• Rest. Avoid activities that involve the affected body part for the first few days after the injury.
• Ice. Apply ice immediately after the injury to keep the swelling down. Use cold packs for 20 minutes at a time, several times a day. Do not apply ice directly on the skin; use an ice pack or place a cloth between the ice and bare skin.
• Compression. To prevent additional swelling, lightly wrap the area in a soft bandage.
• Elevation. As often as possible, rest with the injured arm, hand, leg, or foot raised up higher than the heart.

This usually limits discomfort and reduces healing time. Proper first aid will minimize swelling and help the doctor establish an accurate diagnosis.

Overuse Injuries

Overuse injuries occur gradually over time, when an athletic activity is repeated so often that parts of the body do not have enough time to heal between playing. Examples of overuse injuries include:

• Achilles tendinitis
• Osgood-Schlatter disease (knee pain)
• Jumper's knee
• Sever's disease
• Shin splints
• Stress fractures
• Throwing injuries in the elbow

Coaches may have more difficulty spotting less severe problems, however, because the pain is mild and the athlete often ignores it. Repeat injuries may turn into overuse conditions, which can put the athlete on the sidelines for the rest of the season.

To keep athletes in the game long-term, overuse injuries need to be diagnosed and treated by a physician as soon as possible. Parents and coaches should be aware of the more common signs of overuse injury. These include:

• Pain that increases with activity
• Swelling
• Changes in form or technique
• Decreased interest in practice

In the growing athlete's musculoskeletal system, pain from repetitive motion may appear somewhere besides the actual site of the injury. For instance, a knee ache in a child or adolescent may actually be pain caused by an injury to the hip.

Whether an injury is acute or due to overuse, a child who develops a symptom that persists or that affects their athletic performance should be examined by a doctor. A child should never be instructed or allowed to "work through the pain."

Concussion

Concussions can occur in contact and non-contact sports with:

•  A direct force to the head (e.g., helmet-to-helmet contact during football, or "heading" a soccer ball)
• A sudden, forced deceleration or direction change

Many concussions are not associated with a loss of consciousness. Common symptoms include headache, difficulty focusing, light sensitivity, fatigue, balance difficulty, and nausea.

After a concussion, the child should not practice or play until they are cleared to return to play by a health professional. A second head impact during the recovery phase from a prior concussion can put athletes at risk for serious neurological consequences.

Most people will be fully recovered by 10 days after a concussion, but some may recover sooner. Once symptoms resolve, the athlete can begin a gradual, guided progression of sports activity as long as they don’t experience symptoms with the progression. Helpful tips to resolve a concussion — aside from time alone — are to avoid bright screens, get plenty of sleep, and avoid activities that require significant mental focus or physical exertion.

Historically, concussions were not thought to be serious injuries (e.g., “they had their bell rung.”)  But, in fact, concussions are significant injuries to the brain and require careful attention to prevent serious consequences. Any youth athlete with significant impact to the head and neck should be evaluated for concussion by an orthopaedic specialist.

Learn more: Sports Concussion

Strategies for Preventing Youth Sports Injuries

There are several strategies that coaches, parents, and athletes can follow to help prevent sports injuries. Most important, athletes should:

• Be in proper physical condition to play a sport (a pre-participation sports physical examination can be very useful in screening for potential problems)
• Know and abide by the rules of a sport
• Wear appropriate protective gear (for example, shin guards for soccer, a hard-shell helmet when facing a baseball pitcher, a helmet and body padding for ice hockey) and footwear
• Know how to correctly use athletic equipment (for example, correctly adjusting the bindings on snow skis)
• Always warm up before playing
• Stay hydrated
• Avoid playing when very tired or in pain

Wearing proper protective gear is essential for preventing sports injuries.

Proper Training

Young athletes need proper training for sports. They should be encouraged to train for the sport rather than expecting the sport itself to get them in shape.

Young athletes also should follow a regular conditioning program (in conjunction with their coach) with incorporated exercises designed specifically for their chosen sport. In addition, a well-structured, closely supervised weight-training regimen may help youngsters prepare for athletic activities.

STOP Sports Injuries

Many sports injuries in young athletes — particularly elbow and knee injuries — are caused by excessive, repetitive stress on immature muscle-tendon-bone units. Doctors are seeing an increase in overuse injuries because many young athletes are focusing on just one sport and are training year-round. The American Academy of Orthopaedic Surgeons has partnered with STOP Sports Injuries to help educate parents, coaches, and athletes about how to prevent overuse injuries. Specific tips to prevent overuse injuries include:

• Limit the number of teams on which your child plays in one season. Kids who play on more than one team are especially at risk for overuse injuries.
• Do not allow your child to play one sport year-round — taking regular breaks and playing other sports is essential to skill development and injury prevention.

Atmosphere of Healthy Competition

Coaches and parents are also responsible for creating an atmosphere that promotes teamwork and sportsmanship.

Youth sports should always be fun. The "win at all costs" attitude of many parents, coaches, professional athletes, and peers can lead to injuries. A young athlete striving to meet the unrealistic expectations of others may ignore warning signs of injury and continue to play with pain.

Young athletes must learn to deal with success and defeat to place events in a proper perspective. The promotion of the "win at all costs" ethic can have both short-term and long-term harmful effects on impressionable young athletes.

Special Considerations

Female Athletes

Sports and exercise are healthy activities for girls and women of all ages. The participation of girls and young women in sports has increased significantly since the passage of Title IX. Occasionally, a female athlete who focuses on being thin or lightweight may eat too little or exercise too much.

When you burn more calories than you consume, you cannot sustain the amount of energy needed for normal daily function and exercise. This causes an energy imbalance, which can happen with or without an eating disorder and can cause long-term health damage.

Three interrelated illnesses may develop when a girl or young woman goes to extremes in dieting or exercise. 

The three conditions are:

• Disordered eating
• Menstrual dysfunction
• Premature osteoporosis (low bone density for age)

These conditions collectively used to be called "The Female Athlete Triad." However, resarch has shown that energy deficiency and its health consequences can affect both females and males, and a new term is now being used: relative energy deficiency in sport (REDs). The female athlete triad is now grouped as a subset of REDs because REDs can affect females and males differently.

Learn more: Relative Energy Deficiency in Sport

Steroid Use

Many young athletes — boys and girls — use illegal anabolic steroids to improve their athletic performance. Steroids have been shown to increase muscle mass, but they can cause serious and potentially life-threatening complications and should be avoided. Most steroids are illegal and are banned by sports organizations.

Learn more: The Risks of Using Performance-Enhancing Drugs in Sports

Sports Supplements

Many athletes of all ages take sports supplements, such as creatine, because they think it will increase strength and improve sports performance.

The U.S. Food and Drug Administration does not regulate nutritional supplements. This means that the supplement products available in stores may vary in amount and quality, and there is no guarantee of safety or purity.

There is also not enough research on the long-term health effects of taking sports supplements, especially in adolescents and children who are still growing.

No matter what your age or health condition, always see your doctor for advice before taking nutritional supplements.

Benefits of Sports Participation

Athletic activity by young people is generally safe with low risks and high benefits. The major goal should be enjoyable participation. Exposure to competitive and noncompetitive sports encourages the development of fitness, motor skills, social skills, and a lifelong appreciation for sports.

 source:Pediatric Orthopaedic Society of North America (POSNA) ,AAOS

 https://orthoinfo.aaos.org/en/staying-healthy/a-guide-to-safety-for-young-athletes/

Sever’s Disease (Calcaneal Apophysitis)

 

Sever's Disease

 Sever’s disease (calcaneal apophysitis) is a type of repetitive strain injury in your child’s heel. Too much strain from activities on their feet causes inflammation in the bone. Your child’s bones are softer when they’re growing, so they’re easier to injure. They’ll need to back off of activities that put stress on their heel until the condition improves.

Sever's disease (also known as calcaneal apophysitis) is one of the most common causes of heel pain in growing children. It can especially bother children who are very physically active. It is an inflammation of the growth plate in the calcaneus (heel).

Sever's disease is caused by repetitive stress to the heel. It most often occurs during growth spurts, when bones, muscles, tendons, and other structures are changing rapidly.

• Children and adolescents who participate in running and jumping sports are at an increased risk for this condition.
• However, less active adolescents may also experience this problem, especially if they wear very flat shoes.

In most cases of Sever's disease, simple measures like rest, over-the-counter medication, and a change in footwear will relieve pain and allow a return to daily activities. In addition, stretching the calf muscles may help decrease the stress on the heel.

Why Does Sever's Disease Develop?

On the bones of children and adolescents, there is a special area where the bone is growing called the growth plate. Growth plates are areas of cartilage located near the ends of bones.

When a child is fully grown, the growth plates close and are replaced by solid bone. Until this happens, the growth plates are weaker than the nearby tendons and ligaments and are vulnerable to trauma.

An X-ray of an adolescent foot shows the open growth plate of the calcaneus, or heel. The X-ray appearance of Sever's disease looks similar to those without symptoms. Your child's doctor may still order X-rays to rule out other causes of pain, like a fracture.

Reproduced from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.

Sever's disease affects the part of the growth plate at the back of the heel. This growth area serves as the attachment point for the Achilles tendon. The Achilles tendon is the strong band of tissue that connects the calf muscles at the back of the leg to the heel bone.

Repetitive stress from running, jumping, and other high-impact activities can cause pain and inflammation in this growth area of the heel. The Achilles tendon pulling at its attachment point can sometimes further irritate the area.

Illustration shows the area where the Achilles tendon attaches (inserts) into the heel bone.

Symptoms of Sever's Disease

Painful symptoms are often brought on by running, jumping, and other sports-related activities. In some cases, both heels have symptoms, although one heel may be worse than the other. Symptoms may include:

• Heel pain and tenderness underneath the heel
• Mild swelling at the heel

The red shading shows the typical areas of pain from Sever's disease.  

Diagnosing Sever's Disease

During the appointment, your child's doctor will:

• Discuss your child's symptoms and general health.
• Conduct a thorough examination of the foot and ankle to determine the cause of the pain. This will include applying pressure to the heel bone on both the bottom of the bone and along the sides. These areas are tender or painful for a child with Sever's disease.
• Possibly ask your child to walk, run, jump, or walk on their heels to see if those movements cause pain.

Treatment for Sever's Disease

Treatment for Sever's disease focuses on reducing pain and swelling. This often means limiting exercise activity. In some cases, rest from activity is required for several months, followed by a strength conditioning program. However, if your child does not have a lot of pain or a limp, it may be safe for them to continue sports participation.

Your child's doctor may recommend additional treatment, including:

• Heel pads. Heel cushions inserted in sports shoes can help absorb impact and relieve stress on the heel and ankle.
• Wearing shoes with a slightly elevated heel. Elevating the heel may relieve some of the pressure on the growth plate.
• Nonsteroidal anti-inflammatory drugs (NSAIDs). Drugs like ibuprofen and naproxen can help reduce pain and swelling.
• Exercises.  Once the pain is beter, your child can start exercises to stretch the calf muscle and strengthen the leg muscles.
• Walker boot. Sometimes, a "walker boot" might be required to immobilize the foot while it heals.

Heel cord stretch. You should feel this stretch in your calf and into your heel.

Outcome

It is not unusual for Sever's disease to recur (come back). This can happen when a child once again increases sports activities. Wearing shoes that provide good support to the foot and heel helps.

Sever's disease will not return once a child is fully grown and the growth plate in the heel has matured into solid bone.

 

SOURCES: AAOS,POSNA, CLEVELAND CLINIC

START Triage: Η Ψυχρή Λογική που Σώζει Ζωές

 

START Triage:

Η Ψυχρή Λογική που Σώζει Ζωές.

​Σε ένα περιστατικό Μαζικών Απωλειών Υγείας (MCI), ο χρόνος είναι ο μεγαλύτερος εχθρός.

Η διαλογή (Triage) δεν είναι μια απλή επιλογή, είναι μια επιχειρησιακή απόφαση που καθορίζει την επιβίωση.

Το σύστημα START (Simple Triage and Rapid Treatment) είναι το παγκόσμιο πρότυπο για την αξιολόγηση τραυματιών σε λιγότερο από 60 δευτερόλεπτα.

 ***Λίγα σενάρια στην επείγουσα προνοσοκομειακή φροντίδα είναι τόσο περίπλοκα και απαιτητικά όσο τα περιστατικά μαζικών απωλειών (Mass Casualty Incidents – MCI). Πρόκειται για καταστάσεις που  λόγω του αριθμού ή της βαρύτητας των τραυματιών απαιτούν ακριβή συντονισμό, ταχεία εκτίμηση και στρατηγική διαχείριση πόρων. Είτε πρόκειται για φυσικές καταστροφές, τροχαία πολλαπλών θυμάτων, επιθέσεις με όπλα είτε τρομοκρατικά χτυπήματα μέθοδοι όπως το START και το JumpSTART (για παιδιά) βοηθούν στη σωστή προτεραιοποίηση των ασθενών ανάλογα με τη βαρύτητα του τραυματισμού.***

 

 

​Ανάλυση των 4 Κατηγοριών:

​ Immediate (Άμεση - Κόκκινο):

Ασθενείς με απειλητικές για τη ζωή κακώσεις που απαιτούν άμεση παρέμβαση (π.χ. απόφραξη αεραγωγού, σοβαρή αιμορραγία).

Αν δεν αντιμετωπιστούν ΤΩΡΑ, δεν θα επιζήσουν.

​ Delayed (Καθυστερημένη - Κίτρινο):

Σοβαροί τραυματισμοί που όμως επιτρέπουν μια μικρή καθυστέρηση στη φροντίδα (π.χ. κατάγματα χωρίς αιμοδυναμική αστάθεια).

​ Minor (Ελαφρά - Πράσινο):

Οι «περιπατητικοί» τραυματίες.

Έχουν ελαφρά τραύματα και μπορούν να περιμένουν ή και να βοηθήσουν.

​ Deceased/Expectant (Μαύρο):

Όσοι έχουν καταλήξει ή έχουν τραύματα μη συμβατά με τη ζωή βάσει των διαθέσιμων μέσων στο πεδίο.

 

​*Πώς αποφασίζουμε. (Ο κανόνας RPM)

​Για να χαρακτηριστεί κάποιος Κόκκινος, ελέγχουμε τρία κρίσιμα σημεία:

​ Respirations (Αναπνοή): > 30 ανά λεπτό.

​ Perfusion (Κυκλοφορία): Απουσία κερκιδικού σφυγμού (ή τριχοειδική επαναπλήρωση > 2 δευτ.).

 ​Mental Status (Νοητική Κατάσταση): Αδυναμία εκτέλεσης απλών εντολών.

 

​Βιβλιογραφία & Πηγές:

​Το σύστημα START αναπτύχθηκε από το Hoag Hospital και το Newport Beach Fire Department (California, USA).

Αποτελεί μέρος της διεθνούς εκπαίδευσης MCI Management και αναγνωρίζεται από οργανισμούς όπως ο FEMA και το American College of Surgeons.

​Credit εικόνας: Impact EMS (@impactems)

​#Triage #STARTtriage #ImpactEMS #FirstResponders #EmergencyMedicine

#MCI #MassCasualty #EMS #Paramedic #TacticalMedicine #LifeSaving #ΠρώτεςΒοήθειες #Διασώστης

#ΕΚΑΒ #ΔιαχείρισηΚρίσεων