Rashes and Fever in Children

Question 1

Roseola INFANTUM

Answer 1

High fever, disappears, then Rash

Question 2

Roseola Infantum

Answer 2

HHV-6

Rash starts on trunk and spares the face

Question 3

Chicken Pox

[Varicella]

Answer 3

“dew drops on rose petal”

+ fever, malaise, anorexia

Question 4

Erythema Infectiosium

Answer 4

Parvovirus B19

Question 5

Erythema Infectiosum

[Parvovirus B19]

Answer 5

“slapped cheek” followed by lacy rash over trunk and arms/legs

adults: arthritis

Question 6

Erythema Infectiosum
[Parvovirus]

prodrome

Answer 6

Starts with fever and URI

Question 7

Measles

Answer 7

Rash start at forehead and move down body

“Koplik spots”
fever
malaise

Question 8

Koplik spots

Answer 8

Measles

Question 9

Coxsackie virus

Answer 9

Hand, foot, and mouth

Question 10

GAS [Group A Strep] causes

Answer 10

Scarlet fever AND

Rheumatic fever

Question 11

Scarlet fever

[GAS]

Answer 11

Red, papular rash starting on neck and moving to trunk and arms/legs
\+
"Strawberry tongue"
sore throat
fever

Question 12

Rheumatic fever

[GAS]

Answer 12

Red, serpiginous (looking like a worm) macules with pale centers

Question 13

Serious complications of Rheumatic fever

[GAS]

Answer 13

Carditis
Polyarthritis
SubQ nodules
Sydenham chorea

Question 14

Meningococcemia

[Neisseria meningitidis]

Answer 14

Red, maculopapular rash progressing to form Petechiae

Question 15

Toxic shock synd

[Staph aureus]

Answer 15

Diffuse red macular rash with peeling palms and soles

Question 16

Typhoid fever

[salmonella]

Answer 16

Maculopapular rash on lower chest and abdomen

“Rose Spots”

Question 17

RMSF

[Rickettsia rickettsii]

Answer 17

Maculopapular rash starting on WRISTS and ANKLES and including palms and soles!!

+ fever, HA, myalgia, arthralgia

Question 18

Lyme dz

[Borrelia Burgdorferi]

Answer 18

Bullseye rash

+Malaise, Bell’s palsy, meningitis, carditis, arthritis, heart block !!!

serious complications

Question 19

Roseola Infantum

Answer 19

usually before age 3

mild URI and High fever –> rash, sparing face

rash often gone in 1-2 days

supportive care

Question 20

Development of rash in clusters followed by malaise, fever, anorexia

dew drops on rose petal

Answer 20

Varicella

Chicken pox

Question 21

Rare cases of chicken pox–> serious complications

Answer 21

Encephalitis
Meningitis
Pneumonitis

or superinfection of vesicles by Group A Strep or Staph aureus

Question 22

How long is chicken pox contagious

Answer 22

4-5 days after appearance of rash or until all lesions have crusted over

Question 23

Dx of chicken pox

Answer 23

usually clinical OR

Tzanck smear or
ID by PCR

Question 24

Tx for Chicken pox

Answer 24

Acyclovir may shorten course IF PT IS OLDER THAN 2 YO and IF STARTED within 24 hr onset sx

Question 25

When is chicken pox [Varicella] vaccine given?

Answer 25

``` 1 YO (12-15 mo) 4 YO (booster) ```

Question 26

Facial rash 2-4 days followed by Lacy, pruritic rash that lasts for 1-2 weeks BUT

Answer 26

can relapse for several months This is Erythema Infectiosum [Parvovirus]

Question 27

Parvovirus - erythema infectiosum is more severe in adults and teens "slapped cheek"

Answer 27

Rheumatic complaints- arthralgias if pt has sickle cell - can lead to Aplastic crisis with Anemia and Leukopenia

Question 28

Risk of pregnant mother with Erythema Infectiosum [parvovirus]

Answer 28

Transmit to baby | Risk of: Fetal hydrops and pregnancy loss

Question 29

Scarlet fever

Answer 29

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

Question 30

1st line tx for Group A strep

Answer 30

PCN | if allergic: cephalosporin, macrolide

Question 31

Rash of Meningococcemia [Neisseria meningitidis]

Answer 31

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

Question 32

Other complications of Meningococcemia

Answer 32

Adrenal hemorrhage Deafness Brain and Kidney infarctions

Question 33

Empiric tx for infant <30 days old with suspected N.Meningitidis

Answer 33

Ampicillin + Gentamicin

Question 34

Empiric tx for adult with suspected N. Meningitidis

Answer 34

Vancomycin + | Ceftriaxone

Question 35

Rash starting on ankles and wrist, spread centrally + Nonspecific fever, HA, arthralgia, myalgia, fatigue

Answer 35

RMSF Give DOXY

Question 36

Serologic eval of RMSF

Answer 36

Low WBC Low platelets Low sodium (hyponatremia) Elevated LFT

Question 37

Prophylaxis for those exposed to Neisseria

Answer 37

Cipro or Rifampin