Exanthems Flashcards
Cough, coryza, and conjunctivitis
What is the most likely diagnosis?
what is the route of entry?
what are other associated symptoms?
Measles- caused by a single straded RNA virus i the Paramyxoviridae family
enters through the nasoendothelium
koplik spots (grey/white spots on buccal mucosa that disappear before the onset of the rash)
the final stage is maculopapular- a head to toe distribution as the high fever is resolving
What are complications of mesasles?
enchephalitis
Subacute sclerosing panencephalitis (SSPE): a rare but fatal degeerative disease of the CNS characterized by behavioral and itellecutal deterioration and seizures that generally develops 7-10 yrs after measles infection
**remember the erythematous patchous associated with measles are located on the face and have a cephalocaudal spreaading pattern
prodrome of a low grade fever, headache, rhinorrhea, malaise, myalgias, sore throat, and lyphadenopathy with a cough 2-5 days before the appearance of a rash.
Skin findings:
What is the most likely diagnosis?
What are complications?
Rubella- an RNA virus from the togaviridae family
this disease is milder than measles
the rose-pink macules and papules that become confluent and present in a cephalocaudal manner
fetal infection may lead to stilbirth, miscarriage, and/or congeital rubella syndrome
Prevent spread to pregnant women with the MMR vaccine- but its a live vaccine, so don’t give it to preggos
rash has a “dew-drop on a rose petal” appearance (vesicular) and the lesions appear simultaneously in different stages of healing. Lesions are very itchy
What is the most likely diagnosis?
how is it spread?
Varicella (herpes family)
varicella is spread through respiratory droplets or direct contact with lesions and has an incubation period of 10-21 days
Pts are contagious for at least 5 days after the onset of the rash or until all of the lesions have crusted
peak incidence is between 9-12 months
very high fever
initially there is an absence of physical findings sufficient to explain the degree of the fever. As it resolves, the rash appears on the trunk and moves to the limbs and face.
Roseola
caused by HHV-6 herpesviridae
commonly seen in babies but is rare in older kids unless immunocompromised
**the rash is blanchable and appears 3 days after the fever
Slapped Cheek appearance (facial flushing)
prodrome of low grade fever, headache, and URI symptoms
the trunk and proximal extremities are quickly covered in a diffuse, macular, erythema with central clearing- lacy, reticulated appearance
What is the most likely diagnosis?
seasonal distribution
Complications
Erythema infectiosum (fith dz) caused by Parvovirus B19.
spread through respiratory droplets and is most common in winter and spring
the rash may wax and wane for 1-3 wks before resolving
**This can be dangerous in children with blood disorders (aplastic anemia in kids with sickle cell)
Fifth dz
when is it transmitted across the placenta?
what are the risks to the fetus?
Fifth dz (Erythema infectiosum) caused by parvovirus B19
has the highest risk early in the pregnancy
Fetal infection can lead to anemia, high output CHF, hydrops fetalis, and fetal demise- but surviving infants tend to be healthy.
*most moms already have immunity
**Parvovirus B19 is a ssDNA
s/s fever, malaise, and exanthem that appears at the same time
What is the most likely diagnosis?
What is the location of the lesions?
seasonal distribution?
Hand-Foot-and-mouth disease caused by an enteroviral (picornavirus- RNA) or coxsakievirus A or B
Lesions are grey-white vesicular lesions that appear on the palms of the hands, soles of feet, and as a maculopapular eruption on the butt.
more common in the summer and fall
What are complications of Hand, foot, and mouth disease
the painful erosions and vesicles in the mouth may lead to anorexia and dehydration
