Measles and Mononucleosis

Question 1

Measles

Answer 1

An acute viral respiratory illness
Fever (up to 105), malaise, cough, coryza (inflammation of the mucous membrane in the nose), conjunctivities (three c’s)

Koplik spots- enanthem followed by a maculopapular rash. Rash appears 14 days after exposures and spreads head to trunk. Contagious 4 days before and 4 days after 90% will develop measles if exposed. If immunocompromised may not develop a rash.

Question 2

Measles Complications

Answer 2

Otitis media, bronchopneumonia, laryngotracheobronchitis, diarrhea.
Acute encephalitis, brain damage.
A fatal degenerative disease can develop 7-10 years after infection.
High risk <5, >20, pregnant, immunocompromised.

Question 3

Measles Management

Answer 3

Testing- obtain serum IGM and throat/nasal swab for PCR, also found in urine.
Vaccination is prevention.

Question 4

Mononucleosis

Answer 4

Viral syndrome
Malaise, fatigue, fever, sore throat, tender lymphadenopathy.
Hallmark findings- Posterior adenopathy, splenomegaly and/or hepatomegaly may be present.
Majority are epstein-barr, but may also be from cytomegalovirus
Generally spread through saliva.

Question 5

Mononucleosis Testing

Answer 5

Diagnosis can be made clinically.
Testing- CBC may show atypical lymphocytes, CMP, elevated LFTS
Monospot- tests for IGM antibodies which are present in 80-90% of patients with mono, but can take several weeks to develop.
Less sensitive in very young children.
Usually positive x6 weeks, up to one year.
EVC & CMV titers.

Question 6

Mononucleosis Treatment

Answer 6

Supportive care
No contact sports x4-6 weeks
Splenic rupture, airway compromise, ITP and others.
Monitor for several weeks, repeat labs or US to evaluate liver/spleen