Dermatology - Viral, Hansen's Flashcards
Rubella effect on fetus greatest risk during
First 4 weeks
5% of fetus exposed to rubella within 4 weeks develop
Microcephaly with mental retardation Congenital heart disease Sensorineural deafness Cataracts Low birth weight Fetal death
Differential diagnosis
Rubella
Most likely
Drug hypersensitivity rxn
Rubeola (measles)
Differential diagnosis
Rubella
Consider
Other viral infection (enterovirus, adenovirus, parvovirus, human herpes virus-6)
Differential diagnosis
Rubella
Rulle out always
Streptococcal scarlet fever
Rare complications of rubella
Peripheral neuritis Optic neuritis Myocarditis Pericarditis Hepatitis Orchitis Hemolytic anemia Encephalitis
Tx
Uncomplicated rubella
Supportive
Tx
Non pregnant individual
Rubella vaccine within 3 days of exposure
recommendation for neonates with rubella syndrome
Supportive care
Contact isolation until 12 months old or if repeated cultures are negative after 3 months age
Rubella vaccime administered as
MMR
12-15 mos
4-6 years
Potential adverse rxn rubella vaccine
Fever
Morbilliform rash
Lymphadenopahy
Arthralgia
Should pregnant women be immunized to rubella
False
Any woman receiving rubella vaccine should not become pregnant for
28 days
T/F
Infants of vaccinated breast feeding mother may become infected with rubella via breastmilk
T
How to detect rubella infection in fetus
Cordocentesis - IgM antibodies
Transmission measles
Direct or airborne contact with infectious droplets
Incubation measles
9-12 days
Measles
Patients contagious if
1-2 days before onset of sx
Up to 4 days after appearance of rash
Needed immunity to control Measles
Humoral
Cell-mediated
Ig involved measles
IgM initially then IgG
Controls viral replication and confers antibody protection
Humoral
Eliminates infected cells
Cell- mediated
Effect of Measles on immunity
Transient immunosuppression
- Depressed delayed hypersentitivity
- Depressed T cell counts
- Inc. Risk bacteria
vaccine measles effect on measles
Less severe sx
Prolonged incubation 14-20 days
Immunosuppressed
Measles presentation
Severe disease
Can present without typical rash
Prodrome Measles lasts for
4 days
Prodrome Measles
Fever 40-40.5 C Malaise Coryza Cough (brassy/ barking) Conjunctivitis (palpebral, lid margin)
Catarrhal inflammation of the mucrous membrane in nose esp by cold or by hay fever
Coryza`
Pathognomonci enanthem of measles
Koplik spots
Koplik spots typically seen
Buccal mucosa, near second molars