25 - 163 - EXANTHEMATOUS VIRAL DISEASES Flashcards
Pathognomonic buccal mucosal finding in measles
Koplik spots
Morbilliform eruption of measles lasts for how many days
3 - 5 days
T/F. Humans are the only natural hosts of measles
True
Mode of transmission of measles
person-to-person contact or airborne respiratory secretions
Measles infectious droplets have been reported to remain airborne for up to how many hours, allowing for easy transmission in public spaces.
2 hours
Incubation period of measles
7 - 21 days
3 stages of measles
- Incubation period
- Prodrome
- Exanthem
Characterize the prodrome of measles
The prodrome consists of fever (as high as 40.5°C [104.9°F]), malaise, conjunctivitis (palpebral, extending to lid margin), coryza, and cough (brassy or barking) and can last up to 4 days.
Koplik spots are the pathognomonic enanthem of measles and develop during the prodrome.
The spots begin as small, bright red macules that have a 1- to 2-mm blue-white speck within them and are typically found on the buccal mucosa near the second molars
Koplik spots occur how many hours prior to the onset of the rash
48 hours
Koplik spots typically occur 48 hours prior to the onset of the rash and only last 12 to 72 hours
Koplik spots last for how many hours only
12 - 72 hours
Koplik spots typically occur 48 hours prior to the onset of the rash and only last 12 to 72 hours
Describe the measles exanthem
The measles exanthem consists of nonpruritic, erythematous macules and papules progressing in a cranial-to-caudal direction. The exanthem begins on the forehead and behind the ears (Fig. 163-2) and spreads to involve the neck, trunk, and extremities (Fig. 163-3). The hands and feet are involved.
Lesions may coalesce, especially on the face and neck. The rash usually peaks within 3 days and begins to disappear in 4 to 5 days in the order that it appeared. Desquamation and brownish dyspigmentation in fair patients can occur as the rash resolves.
Measles virus detection is most successful when collection occurs within how many days of the rash’s onset.
3 days
Give laboratory diagnostic tests for measles
- real-time reverse transcription polymerase chain reaction (PCR)
- serologic studies: (+) serum IgM antibody for measles confirms diagnosis; IgM is positive on the 1st day of the rash and remains positive for at least 30 days; fourfold increase in IgG titers (serum must be withdrawn in the convalescent stage)
Uncomplicated measles will last for how many days
10 - 12 days
When is a measles patient considered infectious
An infected patient is considered to be contagious 5 days prior to the onset of the rash until 4 days after the onset of the rash.
What are the complications of measles
- severe diarrhea;
- pneumonia (either viral or superimposed bacterial infection);
- otitis media;
- transient immunosuppression with lymphopenia and decreased cell-mediated immunity;
- encephalitis, and
- a rare form of a progressive neurodegenerative disease termed subacute sclerosing panencephalitis
What is the second line treatment of measles
Ribavirin
First-line treatment for Measles
■ Immunoglobulin, IM
■ Measles vaccine
■ Supportive care
■ Treat secondary infections
■ Vitamin A
Post-exposure prophylaxis can be given to which patients
Individuals at risk for severe illness and complications (infants younger than 1 year of age, pregnant women, unimmunized, and immunocompromised) should be given measles immunoglobulin if presenting within 6 days of exposure.
Individuals at risk for severe illness and complications (infants younger than 1 year of age, pregnant women, unimmunized, and immunocompromised) should be given measles immunoglobulin if presenting within how many days of exposure.
6 days of exposure
Measles immunoglobulin can be given either via an IM (0.5 mL/kg; maximum dose: 15 mL) or IV route (400 mg/kg).
In healthy individuals, the measlesmumps-rubella (MMR) vaccine should be given to boost immunity if it can be administered within how many hours of measles exposure
72 hours
The American Academy of Pediatrics, recommends MMR at what age
12 - 15 months and then again prior to school entry, between 4 and 6 years old.
Infectious stage of german measles
Infected individuals shed virus for 5 to 7 days before and up to 14 days after onset of rash
The risk is greatest to a fetus exposed to the rubella virus in the what trimester
1st trimester
Characterize the prodrome of german measles
The prodrome is characterized by low-grade fever, myalgia, headache, conjunctivitis, rhinitis, cough, sore throat, and lymphadenopathy; symptoms that may last up to 4 days and often resolve with appearance of rash.
What do you call the enanthem of german measles consisting of tiny red macules on the soft palate and uvula
Forchheimer spots
T/F: Forchheimer spots are pathognomonic for rubella
FALSE
Incubation period of german measles
14 - 17 days
