Chicken Pox and Other Viral Rashes (2)

Question 1

Chicken Pox:
What is it caused by?

How does it present?

What can it lead to if infected during pregnancy?

Answer 1

➊ VZV

➋ • Widespread, urticarial, erythematous, raised, vesicular, blistering lesions that scab over a few days (no longer contagious at this point)
• Fever
• General fatigue and malaise

➌ Congenital Varicella Syndrome

Question 2

How is it managed?

What are its complications?

Answer 2

➊ • Self-limiting w/supportive management
• Prevent itch – Long sleeves, keep nails short, antihistamine (chlorphenamine)
• Aciclovir in neonates, the immunocompromised, and those at risk of complications
• Give non-immune pregnant women VZV Ig as protection

➋ • Dehydration
• VZV Latency in sensory dorsal root ganglion cells – Can reactivate later in life as Shingles or Ramsay Hunt syndrome (facial nerve)
• Congenital Varicella Syndrome if infected during pregnancy

Question 3

Rubella:
How does it present?
→ How is it differentiated from Measles?

How is it managed?

What are its complications?

Answer 3

➊ Erythematous macular rash, Fever, Arthralgia, Lymphadenopathy
→ Rash typically starts on face and moves down the trunk, sparing the limbs

➋ Self-limiting w/supportive management, Notify public health

➌ Thrombocytopenia, Encephalitis, Congenital Rubella Syndrome if infected during pregnancy (Triad of Deafness, Cataracts, PDA)

Question 4

Measles:
How does it present?
→ How is it differentiated from Rubella?

How is it managed?

What are its complications?

Answer 4

➊ Koplik spots in mouth (grey), Fever, Coryzal symptoms, Conjunctivitis
→ Rash involves the limbs

➋ Self-limiting w/supportive management, Notify public health

➌ Pneumonia, Diarrhoea → Dehydration, Encephalitis, Meningitis

Question 5

Mumps:
How does it present?

How is it investigated?

How is it managed?

What are its complications?

Answer 5

➊ • Initial flu-like symptoms (Prodrome) - Fever, myalgia, lethargy, headache
• Parotid swelling – Unilateral/Bilateral and painful
• Epididymo-orchitis

➋ PCR of saliva swab

➌ Self-limiting w/supportive management, Notify public health

➍ • Pancreatitis
• Meningitis
• Sensorineural hearing loss