Childhood infections

Question 1

Chickenpox

Answer 1

fever initially itchy, rash starting on head/trunk before spreading. Initially macular then papular then vesicular Systemic upset is usually mild

Question 2

Measles

Answer 2

prodome: irritable, conjunctivitis, fever koplik spots: white spots on buccal mucosa rash: starts behind ears then to whole body, discrete maculopapular rash becoming blotchy and confluent

Question 3

Mumps

Answer 3

fever, malaise, muscular pain, parotitis (earache, pain on eating) unilateral then becomes bilateral

no rash

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

Answer 5

also known as fifth disease or ‘slapped cheek syndrome’ caused by parvovirus B19 lethargy, fever, headache

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 face

Question 7

hand food 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 feet

Question 8

Kawasaki Disease

Answer 8

Idiopathic self limiting systemic vasculitis

Fever lasting > 5 days

Strawberry tongue

Bilateral conjunctivitis, widespread non vesicular rash, cervical lymphadenopathy

Treat with IVIg

Complications: coronary artery aneurysms, sudden death, MI, pericarditis etc

Question 9

Impetigo

Answer 9

70% non bullous, causative organism is staph aureus

tiny pustules that evolve rapidly into honey coloured crusted plaques

if condition is localised: topical mupirocin or fusidic acid, otherwise flucloxacillin