Red rashes in children Flashcards
What are the 6 red rashes
First disease: Measles
Second disease: Scarlet Fever
Third disease: Rubella (AKA German Measles)
Fourth disease: Dukes’ Disease
Fifth disease: Parvovirus B19
Sixth disease: Roseola Infantum
What virus causes measles
Measles virus
How is measles spread
Highly contagious via respiratory droplets
Presentation of measles
Symptoms start 10 – 12 days after exposure
Fever, coryzal symptoms and conjunctivitis
Koplik spots
Rash starts on the face, commonly behind the ears
Rash is an erythematous, macular rash with flat lesions
Koplik spots
Greyish white spots on the buccal mucosa appear 2 days after fever
How long does measles take to resolve
Self resolving after 7 – 10 days
Management of measles
Children should be isolated until 4 days after their symptoms
Measles is a notifiable disease - report to public health
Complications of measles
Pneumonia Diarrhoea Dehydration Encephalitis Meningitis Hearing loss Vision loss Death
What organism causes scarlet fever
Group A streptococcus - strep pyogenes
Pathophysiology of scarlet fever
Caused by an exotoxin produced by the streptococcus pyogenes
Presentation of scarlet fever
Red-pink, blotchy, macular rash with rough “sandpaper” skin that starts on the trunk and spreads outwards.
Patients can have red, flushed cheeks.
Other features: Fever Lethargy Flushed face Sore throat Strawberry tongue Cervical lymphadenopathy
Treatment of scarlet fever
Phenoxymethylpenicillin (penicillin V) for 10 days
Notifiable disease - public health
Children should be kept off school until 24 hours after starting antibiotics
Slapped cheek syndrome (erythema infectiosum) presentation
Mild fever, coryza and non-specific viral symptoms such as muscle aches and lethargy.
After 2 – 5 days the rash appears rapidly - diffuse bright red rash on both cheeks
Days later -reticular mildly erythematous rash affecting the trunk and limbs appears that can be raised and itchy
What organism causes slapped cheek syndrome
Parvovirus B19
Management of erythema infectiosum
Self limiting
Do not need to stay off school
How long does the rash last for in erythema infectiosum
1 – 2 weeks
Patients at high risk of complications from erythema infectiosum
Immunocompromised patients
Pregnant
Haematological conditions:
- sickle cell anaemia
- thalassaemia
- hereditary spherocytosis and haemolytic anaemia.
Investigations for erythema infectiosum in high risk patients
Serology testing for parvovirus to confirm the diagnosis
FBC and reticulocyte count for aplastic anaemia
Complications of erythema infectiosum
Aplastic anaemia
Encephalitis or meningitis
Pregnancy complications including fetal death
Rarely hepatitis, myocarditis or nephritis
Causative organism for roseola Infantum
Human herpesvirus 6 and 7
Presentation of roseola
Presents 1 – 2 weeks after infection
Sudden high fever, lasts for 3 – 5 days and then disappears suddenly.
May be coryzal symptoms, sore throat and swollen lymph nodes
When the fever settles, the rash appears for 1 – 2 days.
Mild erythematous macular rash across the arms, legs, trunk and face and is not itchy
Management of roseola
Self limiting
How long does roseola last for
1 - 2 weeks
Do not need time off nursery
Complication of roseola
Febrile convulsions
If immunocompromised:
- thrombocytopenia
- myocarditis
- Guillian Barre syndrome
