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

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 and confluent

Question 3

Mumps

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 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
‘Slapped-cheek’ rash spreads 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) (‘sandpaper rash’)

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
*Children do not need to be excluded from school

Question 8

Roseola infantum (exanthem subitum / sixth disease)

Answer 8

Human herpes virus 6 (HHV6)
Incubation period 5-15 days
Typically affects children aged 6 months - 2 years

Features - high fever lasting a few days followed by a maculopapular rash, febrile convulsions (10-15%), diarrhoea and cough

Complications - aseptic meningitis, hepatitis