Pediatric Exanthems Flashcards
What is an exanthem
an eruption on the skin as a symptom of disease
what is an enanthem?
an eruption on a mucous membrane as a symptom of disease
fever and rash in a child is _____ until proven otherwise
meningitis
Describe Rubeola:
-This is measles or 10 day measles.
-It is highly contagious : 90% infection rate exposed susceptible individuals. RNA virus, paramyxoviridae family
4 main stages:
1. incubation: 8-12 days post exposure, contagious until 4 days after appearance of rash
2. prodome: cough, coryza, conjunctivitis, KOPLIK SPOTS (12 hours)
3. rash: red,macuolpapular rash with HIGH fever. begins on head and spreads downward.
4. recovery: fades in same pattern, brown and desquamates
Associated symptoms: Otitis Media, bronchopneumonia, photophobia.
can give IV vitals in severe cases.
RARE CASE: SUBACUTE SCLEROSING PANENCEPHALOPAHTY!!! (sets in 8-10 years later)
Scarlet Fever
causative organism: streptococcus pyogenes: GROUP A STREP!
Presentation: incubation is 7 days. RAPID onset of fever, chills, vomiting, HA, abdominal pain, tonsils are RED with EXUDATES. tongue is = strawberry tongue.
-rash sets on at same time as fever!!!! starts in axilla, remains mostly on trunk. SPARES THE FACE!
-circumoral pallor
- sudamina, pastia lines, and desquamation
-RAPID strep is only 70% sensitive, and needs a culture.
TREATMENT: PEN VK
Describe Rubella:
3 day measles. major complication is the severe congenital anomalies which occur with infection of susceptible host during pregnancy. HIGHLY CONTAGIOUS. causative organism = rubivirus
prodrome= catarrhal symptoms : low grade fever, ocular pain, sore throat, myalgias. lympadenopathy occurs 24 hours before rash.
DAY 1: BEGINS ON FACE (not hairline) and spreads to extremities within a few hours.
day 2: maculopapular rash
day 3: clears, mild desquamation
associated symptoms: polyarthritis, and forscheimer spots
INFANTS: can have blueberry muffin syndrome, they can have growth retardation, congenital cataracts, sensorineural hearing loss, etc
non-congenital : self-limited, supportive
congenital: chronic, persistent infection, infants shed virus for 1 year.
Erythemia infectious:
“fifths disease”. spread by respiratory secretions. can cause aplastic anemia. infection during pregnancy can cause fetal hydrops. caused by Parvovirus b19, DNA virus
- mild systemic illness (fever, malasie, HA)
- distinctive rash 7-10 days later. lacy, reticular rash on extremities. noninfectious once the rash appears.
complications: parovirus b19 affects RBC prescurors in the bone marrow, can lead to anemia in unhealthy children.
self-limiting, supportive with hydration and antipyretics.
Describe roseola:
mild viral illness caused by HHV 6. 3-4 days of HIGH fever. fever breaks–> rash appears. maculopapular. rash BEGINS on trunk and spreads. associated with 1/3 of all febrile seizures. mild sore throat. WBC will be elevated during the 1st 24-36 hours of fever, with high neutrophil count. and then it drops. TREATMENT: self limited
varicella
chicken pox. herpesvirus…dna virus. can have this up to 3 weeks. child will have fever, malaise, anorexia prior to rash eruption. virus is aerolsized in the liquid blisters. very bad for mom to get chicken pox while pregnant. self limited but oral acylcovir can be given if severe.
what is hand foot mouth>
caused by coxsackievirus.
fever, anorexia, sore throat
oval blisters on hands, feet mouth
highly infectious
