Febrile exanthems of childhood

Question 1

MEASLES (aka rubeola)

• Organism
• Clinical features
• Rash appearance
• Precautions

Answer 1

• Measles virus
• Cough, coryza, conjunctivitis, koplik spots
• Coalescent rash
• Airborne precautions

Question 2

RUBELLA (German measles)

• Organism
• Clinical features
• Rash appearance
• Congenital infection syndrome

Answer 2

• Rubella virus
• Cervical lymphadenopathy
• Rose-pink rash that does not coalesce, mild fever, arthralgias, lymphadenopathy, etc.
• Congenital infection: deafness, ophthalmologic defects, cardiac defects

Question 3

CHICKENPOX

• Organism
• Rash appearance
• Precautions

Answer 3

• Varicella virus
• “Dew drop on rose petal” appearance, crops of lesions at different stages
• Airborne precautions

Question 4

ERYTHEMA INFECTIOSUM

• Organism
• Rash features
• Infectious period

Answer 4

• Parvovirus B19
• Slapped cheek rash. Lacy reticular rash on trunk.
• No longer contagious once rash appears

Question 5

ROSEOLA

• Organism
• Clinical features
• Infectious period

Answer 5

• HHV6
• High fevers for 3-5 days followed by rash
• Not contagious once rash appears

Question 6

SCARLET FEVER

• Organism
• Clinical features

Answer 6

• Group A strep (if GAS negative, consider arcanobacterium haemolyticum)
• Pharyngitis and sandpaper rash

Question 7

HAND, FOOT & MOUTH

• Organism
• Clinical features

Answer 7

• Coxsackie or other enteroviruses

- Papulovesicular lesions on hands, feet and in mouth (soft palate or pharyngeal wall)