L3 Viral Exanthems

Question 0

Measles complications, Tx, prevention

Answer 0

• ear infection, diarrhea, pneumonia
• encephalitis, death (1:1000) (27 deaths per hr)
• Tx: sx only (virus) - antiprupitic, hydration
  Vitamin A
• !!! Prevent by immunization MMR !!!
• tx household contact with immunoglobulin/preg’s avoid

Question 1

Measles Dx

Answer 1

• Clin presentation

- Serology - Mealses specific IgM

Question 2

MMR Vaccine

Answer 2

2 doses: given at 12-15 months and 4-6 yo

Protect ind. chile and community

Question 3

Erythema Infectiosum

Answer 3

• Pivovirus B-19
• school kids (in adults - no slapped cheek rash)
• incubation 9-21 days
• Prodrome (rare) - 3 days, mild fever
• facial rash - red slapped cheek
• rash on trunk and extremeties (lacy, reticular?) - 2-3 days AF face
• polyarthropathy (pain in hand feet joints) >50% adults

Question 4

Measles (Rubeola) Gen

Answer 4

• by Paramyxovirus; respiratory droplets
• erythematous, blanching, maculopapular
• HEAD to TOE (ask pt where started)
• Incubation: 9-14 days (sx free)
• Prodrome (sx BF rash): Fever + 3 C’s:
  Cough, Corysa (rhinitis), Conjuctivitus
• KOPLIK spots (2 days after rash) cluster of bluish-white papules on buccal mucosa with erythema (“grains of salt on red”)

Question 5

Erythema Infectiosum Dx + Mngt

Answer 5

• clin presentation: Hx and physical
• Parvovirus B19 IgM ABs
• Quantitative PCR for Parvovirus B19 DNA
• Mngt: sx tx (fluids)
  blood transfusion and immune globulin for severe anemia
  avoid pregs
  no vaccine (but 50% immune due to exp’re in childhood)

Question 6

Rubella (german measles)

Answer 6

• Rubella virus / Resp droplets
• Contagious a week BF and AF rash
• Incubation: 14-21 days
• ## Prodrome (rare): 1-5 days, fever anorexia