Infectious Rash Flashcards
What causes a non-blanching rash
Bleeding under the skin
What are petechiae
Small non-blanching spots on the skin caused by burst capillaries
What are purpura
Larger non-blanching red/purple macules or papules created by leaking of blood from vessels under the skin
Causes of rash in children
Septicaemia, parvovirus, hand foot and mouth disease, scarlet fever, measles, uticaria, chicken pox, roseola features, rubella features
Cause of hand foot and mouth disease
Coxsackie virus and incubation is usually 3-5 days
Presentation of hand foot and mouth disease
Illness starts with typical viral URTI such as tiredness, sore throat, dry cough, raised temp, then after 1-2 days small mouth ulcers appear. Then blistering spots across body, most notable on hands feet and mouth, may be itchy
Management of hand foot and mouth disease
Supportive management, highly contagious, resolves after 7-10 days
Diagnosis of hand foot and mouth
Clinical appearance of rash
What is erythema multiforme
Erythematous rash caused by hypersensitivity reaction
Common cause of erythema multiforme
Most commonly viral infections (HSV) and medications
Only bacterial cause of erythema multiforme
Mycoplasma pneumoniae
Presentation of erythema multiforme
Widespread itchy rash, target lesions, can cause stomatitis, abruptly appears over few days, fevers, muscle and joint ache, flu-like symptoms
Management of erythema multiforme
Mild and often resolves spontaneously, Abx if bacterial cause in vulnerable, supportive management ruquiring admittance to hospital
Diagnosis of erythema mulriforme
Diagnosis from rash, identify underlying cause, CXR to look for mycoplasma pneumoniae
Symptoms of measles
Fever above 40 degrees, coryzal symptoms, conjunctivitis followed by rash about 2-5 days after onset, Koplik spots
When do symptoms of measles appear
Symptoms develop 10-14 days post exposure to infection and last for 7-10 days
What are Koplik spots
Small grey discolouration of the musosal membranes in mouth and appear 1-3 days after symptoms begin
Diagnosis of measles
1st - IgM and IgG serology most sensitive 3-14 days atfer onset of rash.
2nd - RNA detection by PCR best for swabs taken 1-3 days after rash onset
Complications of measles
Acute otitis media, bronchopneumonia, encephalitis
Management of measles
Supportive care, Vit A in children under 2m Ribavarin not routinely used
Presentation of parvovirus B19
Prodrome of fever, coryza and diarrhoea, after there is diffuse lace like rash across body, bright red rash on cheeks
Complications of parvovirus B19 in pregnancy
Infection within first 20 weeks can cause foetal anaemia which can precipitate hydrops foetalis and subsequent miscarriage
Presentation of roseola infantum
Children can be febrile and lethargic for up to 5 daysm after fever subsides a blanching rose pink macular rash erupts and typically covers trunk
Presentation of rubella
Non-specific symptoms and signs such as fever, coryza, arthralgia, rash, classically starting at face and moves down trunk, lymphadenopathy, rash typically spares limbs
How is mumps spread and incubated
Viral infection spread by respiratory droplets, with an incubation period of around 14-25 days
Presentation of mumps
Initial period of flu-like symptoms few days before parotid swelling. Then fever, muscle aches, lethargy, reduced appetite, headache, dry mouth, parotid swelling can be unilateral or bilateral and associated pain
Complications of mumps
Pancreatitis, testicular pain and swelling, ochitis, adn confusion, neck stiffness and headache, sensorineural hearing loss
Management of mumps
Confirmed using PCR testing on savliva swab testing for antibodies. Supportive management and management of complications
