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Fast Fact
More than 100 different types of Group A Beta Strep have been identified.
Common sites of infection include the upper respiratory tract; scarlet fever, which includes skin involvement and can be very mild or extremely serious; strep pneumonia (which can also be quite serious); strep skin infections (such as impetigo); strep vaginitis in pre-pubertal girls; and strep bacteremia (or strep in the bloodstream), which can then lead to meningitis, brain abscess, bone infections, joint infections, or even endocarditis (an infection of the valves of the heart).
Strep pharyngitis (commonly known as “strep throat “) is one of the most common strep infections. Strep throat is contagious until antibiotic therapy has been in place for at least 24 hours. It is spread by close contact, both via respiratory droplets and by touch.
The diagnosis of a systemic strep infection should at least be entertained when there is vomiting lasting longer than 24 hours, a high fever, and an elevated white blood count in an ill-appearing child.
The presence of strep infection can be confirmed by performing a culture of the suspected site. Depending on a child’s symptoms, a throat culture, wound culture, blood culture, and/or a blood test may be obtained to evaluate for strep infection.
In the case of strep throat, rapid strep tests can give almost immediate results in the doctor’s office but may miss 10 to 20% of infections. Throat cultures may take 1 to 2 days, but are able to detect infection 95% of the time.
Do nightmares do anything more than just scare kids? Do they serve any purpose? Do newborns have nightmares?
Nightmares are an important means of addressing difficult events and emotions to weave them into the fabric of our minds in a constructive way. Traumatic events are known to cause a predictable pattern of nightmares: first come dreams that relive the event, then dreams that relive the primary emotion of the event using different scenarios (different pictures), then dreams that incorporate aspects of the event into other parts of life.1
Nightmares are generally thought to be most common at the ages of 3 to 5 years --the peak ages when children express fears -- they are said to begin around that time, or shortly before. Conventional wisdom tells us that nightmares begin not too long before then.
The available evidence leads me to a vastly different conclusion: that just like other dreams, nightmares are most common in infancy. Stressful events, such as injections, circumcision (which should never be done without anesthesia), being left alone or dropped, or even feeling hungry, need to be learned about and integrated. It seems to me that anything worth crying about is worth dreaming about.
We know from older children that nightmares commonly follow surgery, tooth extraction, and motor vehicle accidents. 2,3,4Why wouldn't they follow the ultimate extraction, childbirth?
We don't want to believe that our little ones experience anything unpleasant. So strong is this desire that it led to the long-held (now finally and forcefully disproved) belief that newborns don't feel pain when circumcised. How absurd!
Knowing how much young babies dream and cry (and wake up crying), it seems equally absurd to me to believe that all of their dreams are happy ones. Birth is a wonderful and terrible experience. There is much to be happy about and much to learn about in the weeks that follow. Babies' dreams must incorporate and address those things that bring them pleasure and those that make them cry. In all likelihood, the peak age of crying, the first 6 weeks, is also the peak age of nightmares.
These nightmares are not unsuccessful dreams. Far from it! They help babies learn and grow. These nightmares may even be an important reason that crying diminishes after 6 weeks.
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