rubeola

Question 1

what are 6 considerations in diagnosing fever/rash?

Answer 1

1. fever (how high)
2. type of rash (maculopapular, vesicular, etc)
3. distribution of rash
4. pattern of onset
5. timing of onset in relation to other symptoms
6. associated symptoms (pharyngitis, kopliks’s spots, etc)

Question 2

what is another term for measles?

Answer 2

rubeola

Question 3

what has a higher incidence of morbidity/mortality than other exanthems?

Answer 3

rubeola/measles

Question 4

what organism causes rubeola?

Answer 4

RNA virus of paramyxoviridae family (humans only host)

Question 5

what are the 4 mains phases of rubeola?

Answer 5

1. incubation
2. prodrome
3. rash
4. recovery

Question 6

explain the incubation phase of rubeola

Answer 6

• 8-12 days from exposure to onset of symptoms
• 14 days to onset of rash
• contagious form 1-2 days prior to onset of symptoms until 4 days after appearance of rash

Question 7

explain the prodrome phase of rubeola

Answer 7

classic symptoms- the 3 c’s for 3 days! –> cough, coryza, conjunctivitis

• followed by pathognomonic appearance of KOPLIKS SPOTS! (gray, pinhead sized dots with surrounding erythema on the buccal membrane)
• Koplik’s spots may last as little as 12 hours therefore it is often missed on PE

Question 8

explain the rash phase of rubeola

Answer 8

• erythematous maculopapular rash often accompanies by high fever (104+)
• begins with faint macules on HEAD (often above the hairline! and around neck and ears)***
  > 2nd day: spread to torso and legs (descends)
  >3rd day: feet involved, areas of confluence (proximally, superiorly)

Question 9

explain the recovery phase of rubeola

Answer 9

rash fades in shame fashion as onset

Question 10

what are some associated symptoms/findings of rubeola?

Answer 10

• photophobia is very characteristic***

- frequently associated with otitis media and bronchopneumonia

Question 11

what are some complications of rubeola?

Answer 11

subacute sclerosing panencephalopathy: latent infection of the brain tissue causes neurologic symptoms –> behavioral/intellectual deterioration and myoclonic seizures 8-10 years post-infection –> DEATH occurs 1-2 years after onset of symptoms…cannot stop this from happening!

Question 12

what are some evaluation/diagnostic techniques if one suspects rubeola?

Answer 12

• primarily a clinical diagnosis
• leukopenia is characteristic
• can be confirmed serologically with IgM and IgG assays (IgM appears within 1-2 days of rash and persists 1-2 months)
• in sclerosing panencephalopathy, high levels of measles antibody exist in serum and CSF

Question 13

how would you treat rubeola?

Answer 13

• no specific treatment
• usually recover in 7-10 days
• avoid strong light (photophobia)
• IV antivirals (ribavirin) in severe cases or in immunocompromised
• HIGH RATE of OM, bronchopneumonia-treatment required
• vit A supplementation in malnourished