Rashes and Fever in Children Flashcards
Roseola INFANTUM
High fever, disappears, then Rash
Roseola Infantum
HHV-6
Rash starts on trunk and spares the face
Chicken Pox
[Varicella]
“dew drops on rose petal”
+ fever, malaise, anorexia
Erythema Infectiosium
Parvovirus B19
Erythema Infectiosum
[Parvovirus B19]
“slapped cheek” followed by lacy rash over trunk and arms/legs
adults: arthritis
Erythema Infectiosum
[Parvovirus]
prodrome
Starts with fever and URI
Measles
Rash start at forehead and move down body
“Koplik spots”
fever
malaise
Koplik spots
Measles
Coxsackie virus
Hand, foot, and mouth
GAS [Group A Strep] causes
Scarlet fever AND
Rheumatic fever
Scarlet fever
[GAS]
Red, papular rash starting on neck and moving to trunk and arms/legs \+ "Strawberry tongue" sore throat fever
Rheumatic fever
[GAS]
Red, serpiginous (looking like a worm) macules with pale centers
Serious complications of Rheumatic fever
[GAS]
Carditis
Polyarthritis
SubQ nodules
Sydenham chorea
Meningococcemia
[Neisseria meningitidis]
Red, maculopapular rash progressing to form Petechiae
Toxic shock synd
[Staph aureus]
Diffuse red macular rash with peeling palms and soles
Typhoid fever
[salmonella]
Maculopapular rash on lower chest and abdomen
“Rose Spots”
RMSF
[Rickettsia rickettsii]
Maculopapular rash starting on WRISTS and ANKLES and including palms and soles!!
+ fever, HA, myalgia, arthralgia
Lyme dz
[Borrelia Burgdorferi]
Bullseye rash
+Malaise, Bell’s palsy, meningitis, carditis, arthritis, heart block !!!
serious complications
Roseola Infantum
usually before age 3
mild URI and High fever –> rash, sparing face
rash often gone in 1-2 days
supportive care
Development of rash in clusters followed by malaise, fever, anorexia
dew drops on rose petal
Varicella
Chicken pox
Rare cases of chicken pox–> serious complications
Encephalitis
Meningitis
Pneumonitis
or superinfection of vesicles by Group A Strep or Staph aureus
How long is chicken pox contagious
4-5 days after appearance of rash or until all lesions have crusted over
Dx of chicken pox
usually clinical OR
Tzanck smear or
ID by PCR
Tx for Chicken pox
Acyclovir may shorten course IF PT IS OLDER THAN 2 YO and IF STARTED within 24 hr onset sx
When is chicken pox [Varicella] vaccine given?
1 YO (12-15 mo) 4 YO (booster)
Facial rash 2-4 days followed by Lacy, pruritic rash that lasts for 1-2 weeks BUT
can relapse for several months
This is Erythema Infectiosum [Parvovirus]
Parvovirus - erythema infectiosum is more severe in adults and teens
“slapped cheek”
Rheumatic complaints- arthralgias
if pt has sickle cell - can lead to Aplastic crisis with Anemia and Leukopenia
Risk of pregnant mother with Erythema Infectiosum [parvovirus]
Transmit to baby
Risk of: Fetal hydrops and pregnancy loss
Scarlet fever
2 days after onset sore throat
“pastia lines” punctate raised red eruptions that become confluent, feel like sandpaper
“Strawberry tongue”
rash fades and desquamation occurs 4-5 days after rash appears
1st line tx for Group A strep
PCN
if allergic: cephalosporin, macrolide
Rash of Meningococcemia [Neisseria meningitidis]
Red maculopapular eruption that does NOT blanch
–> petechaie
may coalesce into purpura in a condition known as “PURPURA FULMINANS” can result in gangrene and amputation if associated with DIC
Other complications of Meningococcemia
Adrenal hemorrhage
Deafness
Brain and Kidney infarctions
Empiric tx for infant <30 days old with suspected N.Meningitidis
Ampicillin + Gentamicin
Empiric tx for adult with suspected N. Meningitidis
Vancomycin +
Ceftriaxone
Rash starting on ankles and wrist, spread centrally
+
Nonspecific fever, HA, arthralgia, myalgia, fatigue
RMSF
Give DOXY
Serologic eval of RMSF
Low WBC
Low platelets
Low sodium (hyponatremia)
Elevated LFT
Prophylaxis for those exposed to Neisseria
Cipro or Rifampin
