Parovirus B19, MMR & Lyme Flashcards
Pathophys of slapped cheek syndrome?
Parvovirus B19 affects erythoblastoid red cell precursors in bone marrow - commonest in spring, and more serious in older children. Can be transmitted through blood products and respiratory secretions.
Clinical presentation of parvovirus B19?
1) Asymptomatic
2) Erythema infectiosum - commonest illness with a phase of fever, malaise, headaches and myalgia - followed by characteristic rash week later on cheek - ‘slapped cheek’: Rash progresses to maculopapular ‘lace’ like rash on trunk and limbs. Child no longer infectious after rash has developed
Complications of Parvovirus B19?
1) Can cause Apoplastic crisis in kids with haemolytic anaemia (sickle-cell).
2) Cause hydrops fetalis death due to severe anaemia
Name 3 enteroviruses and route of transmission?
1) Includes coxsackie, echovirus, poliovirus
2) Faecal oral route transmission
3) 90% asymptomatic, or nonspecific febrile illness
4) Sometimes rash over trunk blanching or fine petechiae
5) Loose stools and vomitting history
6) If rash is non-blanching - TREAT AS MENINGOCOCCAL (IV ceftriaxone).
Give 3 examples of complications/conditions caused by enteroviruses?
1) Hand foot and mouth disease - vesicular lesions on hand, foot and mouth, and buttocks, disease goes away after few days - treat with fluids and analgesia.
2) Herpangina
3) Meningitis/encephalitis
Measles clinical presentation?
FCCCK
1) Fever, coryza, conjuctivitis, cough
2) Koplik spots (white spots on buccal mucosa seen on bright red background) like grains of salt on red background - fade as maculopapular rash appears
3) Maculopapular rash spreading downwards from behind the ears to the whole body - become blotchy from maculopapular
Management of measles?
1) Isolated, symptomatic
2) Antiviral - Ribavarin
3) Immunsation (MMR VACCINE)!!!!
Complications of measles?
1) Encephalitis
2) SSPE - Subacute sclerosing panencephalitis - most have had primary measles infection before 2 years (loss of neuro function progresses over several years to dementia and death, characteristic EEG abnormalities
Mumps pathophys and transmission:
1) Droplet infection - virus replicates in epithelial cells and enters parotid gland and disseminates to other tissue
2) Incubation period of 15-24 days
3) Infective for up to 7 days after parotid swelling
Presentation of mumps?
1) Beginning - fever, malaise, parotitis (one side then bilateral) - earache
2) Hearing loss is unilateral and transient
3) Orchitis - testicular swelling
4) Parotid gland is red and swollen - hamster
Mumps investigation?
Plasma amylase elevated (ass w/ abdo pain and pancreatic involvement)
Rubella (German measles) pathophys:
- Mild disease in kids spread via respiratory route - can cause severe damage to foetus.
- Incubation period of 15-20 days
Rubella presentation, Dx and Tx?
Prodrome = mild with low grade fever
- Maculopapular rash first sign of infection - on face first (fades 3-5 days)
- CCCK of measles - cough, coryza, conjunctivitis + kopek spots
- No itchy rash unlike with adults
- Lymphadenopathy prominent
Dx: serological if any risk of exposure of non-immune pregnant women
Tx: Symptomatic, no antiviral works
Lyme disease cause and transmission?
Borrelia Burgdorferi (transmitted by hard tick, hosts are deer and moose) Incubation period of 4-20 days
Lyme disease clinical features?
1) Erythematous macule - at site of tick bite
2) This enlarges - leading to a classical skin lesion erythema migrans (painless expanding red lesion)
3) Early disease: Fever, headache, myalgia, arthralgia, lymphadenopathy
4) Late disease after weeks: neurlogical, cardiac, and joint manifestations
