Childhood infections

Question 1

Describe how chicken pox rash presents

Answer 1

Itchy, rash starting on head/trunk before spreading. Initially macular then papular then vesicular

Question 2

Describe features of measles

Answer 2

Prodrome: irritable, conjunctivitis, fever
Koplik spots: white spots (‘grain of salt’) on buccal mucosa
Rash: starts behind ears then to whole body, discrete maculopapular rash becoming blotchy & confluent

Question 3

Describe how mumps presents?

Answer 3

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

Question 4

Rubella

Answer 4

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

Question 5

Erythema infectiosum (‘fifth disease’)

Answer 5

Caused by parvovirus B19
Lethargy, fever, headache
‘Slapped-cheek’ rash spreading to proximal arms and extensor surfaces

Question 6

Scarlet fever

Answer 6

Reaction to erythrogenic toxins produced by Group A haemolytic streptococci
Fever, malaise, tonsillitis
‘Strawberry’ tongue
Rash - fine punctate erythema sparing the area around the mouth (circumoral pallor)

Question 7

Hand foot and mouth disease

Answer 7

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