Exanthems Flashcards
1
Q
Define exanthem
A
- widespread rash
- usually in children
- toxins, drug, microbes, autoimmune
2
Q
Three exanthems we will study
A
- Erythema infectiosum (Fifth disease)
- Hand, Foot, Mouth disease
- measles
3
Q
Erythema infectiosum
- aka
- causative organism
- timing
- incubation
- transmission
A
- aka Fifth disease
- caused by Parvovirus B19**
- late winter/early spring
- incubation 4-14 days
- respiratory route, aerosolized droplets
4
Q
Erythema infectiosum
- clinical findings in children
A
- MC asx
- nonspecific sx: HA, coryza, low-grade fever
- pharyngitis, malaise, myalgias, diarrhea, nausea, cough, conjunctivitis
- 10% arthralgia or arthritis, lrg joints
5
Q
Erythema infectiosum
- rash specific clinical findings
A
- begins with confluent, erythematous, edematous plaques on cheeks “slapped cheek”
- fades 1-4 days
- then pink to erythematous macule or papules on trunk, neck, extensor surfaces
- lesions have central fading = reticulated appearance
- usually no pruritus
- lasts 5-9 days, can recur with triggers (sunlight, exercise, temp change, bath, emotional stress)
6
Q
Erythema infectiosum
- adult clinical findings
A
- acute arthropathy is primary finding (MC women)
- symmetric polyarthritis of small joints (hand, knee)
- self-limiting
- can persist/recur for months
- constitutional sx more severe than in children
- Fever, adenopathy, mild arthritis w/o rash most common
- rash if present: reticulated on extremities, rarely slapped cheek
7
Q
Erythema infectiosum
- dx
A
- based on clinical findings
- labs usually normal
- IgM anti-HPVB19 antibodies or IgG seroconversion or PCR for B19 DNA possible
8
Q
Erythema infectiosum
- major complications (2)
A
- Transient aplastic crisis
- Fetal B19 infection
9
Q
Erythema infectiosum
- Transient aplastic crisis
A
- cessation of RBCs
- MC cause in patients with chronic hemolytic anemia
- fatigue, pallor, worsening anemia
10
Q
Erythema infectiosum
- Fetal B19 infection
A
- **spontaneous abortion (first half)
- **hydrops fetalis (fluid in compartments like lung or brain)
- late fetal death
- congenital anemia
11
Q
Erythema infectiosum
- treatment
A
- none, usually not needed
- supportive therapy for fatigue, malaise, pruritus, arthralgia
- offer serologic B19 testing to pregnant women exposed to B19 (follow with frequent US)
12
Q
Hand-Foot-and-Mouth Disease
- demographics
- timing
- transmission
- pathogen
A
- Children <10 MC
- summer and fall
- highly contagious
- oral-oral and fecal-oral
- Coxsackievirus A16 and enterovirus 71
13
Q
Hand-Foot-and-Mouth Disease
- clinical findings
A
- first: low-grade fever, malaise, abd pain, URI sx
- nearly all: painful oral lesions on tongue, buccal mucosa, hard palate
- later: 2/3 get cutaneous lesions on hand, feet, buttocks (occasionally genitalia, face, legs)
- red macule and papules > vesicle with red halo > crust/erosion
14
Q
Hand-Foot-and-Mouth Disease
- diagnosis
A
- clinical dx
- no labs
15
Q
Hand-Foot-and-Mouth Disease
- tx
A
self-limiting in 7-10 days
- supportive tx only
