childhood infection

Question 1

Mumps features

Answer 1

muscular pain
Parotitis (‘earache’, ‘pain on eating’): unilateral initially then becomes bilateral in 70%

Question 2

Rubella

Answer 2

pink maculopapular, initially on face before spreading to whole body, usually fades by the 3-5 day
Lymphadenopathy: suboccipital and postauricular

Question 3

Scarlet fever features

Answer 3

tonsillitis

Sore throat

‘Strawberry’ tongue / white curdling of tongue

Rash - first on torso / fine punctate erythema sparing the area around the mouth (circumoral pallor)/ spares palms and soles
Described as sandpaper

Question 4

Hand, foot and mouth disease cause and features

Answer 4

coxsackie A16 virus
Mild systemic upset: sore throat, fever
Vesicles in the mouth and on the palms and soles of the feet

Question 5

Roseola infantum caused by

Answer 5

human herpes virus 6 (HHV6)

affects children aged 6 months to 2 years.

Question 6

features of Roseola infantum

Answer 6

high fever: lasting a few days

Then a maculopapular rash starting at the trunk

Nagayama spots - : papular enanthem on the uvula and soft palate

febrile convulsions occur in around 10-15%

diarrhoea and cough are also commonly seen

Question 7

Roseola infantum, Other possible consequences

Answer 7

aseptic meningitis
hepatitis

Question 8

Mumps mx and prevention

Answer 8

Prevention :MMR vaccine

Rest/ paracetamol / notifiable disease

Question 9

Mumps complications

Answer 9

Orchitis
Hearing loss
Meningoencephalitis
Pancreatitis

Question 10

Measles features

Answer 10

conjunctivitis

Koplik spots
develop before the rash
white spots (‘grain of salt’) on the buccal mucosa

rash
starts behind ears then to the whole body
discrete maculopapular rash becoming blotchy & confluent
spares the palms and soles may occur after a week
diarrhoea occurs in around 10% of patients

Question 11

Measles complication

Answer 11

otitis media: the most common

pneumonia: the most common cause of death

encephalitis

subacute sclerosing panencephalitis: very rare, may present 5-10 years following the illness
febrile convulsions

keratoconjunctivitis, corneal ulceration

diarrhoea

increased incidence of appendicitis
myocarditis

Question 12

Management of scarlet fever

Answer 12

oral penicillin V for 10 days
patients who have a penicillin allergy should be given azithromycin
children can return to school 24 hours after commencing antibiotics

Question 13

Scarlet fever complications

Answer 13

otitis media: the most common complication

rheumatic fever: typically occurs 20 days after infection

acute glomerulonephritis: typically occurs 10 days after infection

invasive complications (e.g. bacteraemia, meningitis, necrotizing fasciitis) are rare but may present acutely with life-threatening illness