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Infectious disease > Viral Exanthems > Flashcards

Viral Exanthems Flashcards

1
Q

any eruptive skin rash that may be associated with fever or other systemic symptoms

A

exanthem

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2
Q

what are the 6 classical infectious childhood exanthems

A
  1. rubeola (measles)
  2. scarlet fever, associated with strep
  3. rubella (german measles)
  4. “Dukes’ disease” - thought to be wrong
  5. erythema infectiosum (parvovirus B19)
  6. roseola infantum (HHV-6 and HHV-7)
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3
Q

incubation of rubeola

A

7-14 d

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4
Q

transmission of rubeola

A
  1. airborne
    - can spread for about 8 days
    - starts 4 days before the rash appears
    - ends when the rash has been present for 4 days.
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5
Q

kids with rubeola are not allows to return to school for ____ after rash appears

A

4 days

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6
Q

s/s of rubeola (measles)

A
  1. Low Grade Fever
    - can be high as 104-105
  2. Dry Cough
  3. Coryza (Runny nose)
  4. Conjunctivitis
  5. Sore throat
  6. Koplik’s spots on buccal mucosa
  7. Red, blotchy skin rash
    - Face (behind the ears and along the hairline) → arms and trunk → thighs, lower legs, and feet
    - recedes - fading first from the face and last from the thighs and feet

Initial symptoms cause a relatively mild illness and may last for 2-3 days

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7
Q

tx for rubeola

A
  1. Supportive care:
    - Increased fluid intake
    - Acetaminophen for fever (No ASA)
    - Antibiotics for complications of bacterial infection
  2. Post-exposure vaccination
    - within 72 hours of exposure to provide protection against the disease.
    - If measles still develops, the illness usually has milder symptoms and lasts for a shorter time

no cure

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8
Q

what is the vax scheduling for rubeola

A
  1. 1st dose - 12-15 months
  2. 2nd dose - 4-6 yrs
    - may be given during any visit
    - at least 4 weeks have elapsed since the first dose and that both doses are administered beginning at or after age 12 mos
  3. no second dose - complete the schedule by the visit at age 11-12 yrs.
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9
Q

what is the incubation of mumps

A

12-25 days after infection

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10
Q

transmission of mumps

A
  1. Airborne
  2. Contact w/ saliva
  3. Contaminated surfaces
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11
Q

isolation of pts with mumps is ___ after their glands begin to swell

A

5 days

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12
Q

if a pt presents with:
Fever
Headache
Muscle aches
Tiredness
Loss of appetite
Parotitis
what is the probable diagnosis

A

mumps

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13
Q

complications with mumps

A
  1. orchitis
  2. encephalitis
  3. oophoritis/mastitis
  4. deafness
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14
Q

prevention for mumps

A
  1. Vaccine – MMR
    - 2 doses of mumps vaccine are 88% effective at preventing the disease
    (one dose is 78% effective)
  2. be clean
    - Washing hands
    - Not sharing eating or drinking utensils
    - Cleaning surfaces that are frequently touched regularly with soap and water or with cleaning wipes
    - Minimize close contact with other people if you are sick
    - Cough and sneeze etiquette
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15
Q

incubation of rubella

A

2-3 wks

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16
Q

transmission of rubella

A
  1. airborne
  2. direct contact
  3. bloodstream from pregnant women
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17
Q

communicable period of rubella (German measles)

A

10 d prior to rash ➤ 1-2 wks after rash disappears

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18
Q
  1. Mild fever
  2. HA
  3. Stuffy or runny nose
  4. Inflamed, red eyes
  5. Symmetrical postauricular and occipital tender LAN
  6. fine, pink rash
    - face and quickly → trunk → arms and legs
    - disappears in the same sequence
  7. Arthralgias
    - especially in young women.
A

rubella

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19
Q

complications with rubella

A
  1. arthritis
    - Women mainly
    - Fingers, wrists, knees
    - Lasts up to 1 month
  2. OM/encephalitis
  3. congenital rubella syndrome
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20
Q

highest risk for congenital rubella syndrome to the fetus is when during the pregnancy?

A

first trimester
but exposure later in pregnancy is also dangerous

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21
Q

If a patient contracts rubella while pregnant and wishes to continue with the pregnancy, she may be given ___ to fight off the infection and reduce symptoms

A

hyperimmune globulin
does not necessarily eliminate the possibility of the baby developing congenital rubella syndrome

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22
Q

what is the classic triad of congenital rubella syndrome

A

Microcephaly
Cataracts
Cardiac defects

23
Q

diagnosis and tx for rubella?
how do you confirm it is rubella?

A
  1. clinically
    - IgM antibody titers - for confirmation
  2. isolation
    - especially pregnant women
  3. tx
    - supportive
24
Q

prevention of rubella

A
  1. Vaccine – MMR
    - Women before getting pregnant (Live, attenuated vaccine)
  2. Once sick = permanently immune
25
Q

incubation of Erythema Infectiosum

A

1-2 wks

26
Q

transmission of Erythema Infectiosum

A
  1. Respiratory secretions
  2. Blood / blood products
  3. Springtime
  4. Transmitted through pregnancy
27
Q

communicable period of erythema infectiosum

A

before rash appears

28
Q

s/s of Erythema Infectiosum

A

1.1st symptoms - mild
- fever, rhinitis, HA
2. 1–2 wks
- fiery-red facial erythema “slapped cheeks”
- 1–4 days after the slapped cheek eruption - lacy (reticular) macular exanthem over the proximal extremities

  • The exanthem can recur bc of certain stimuli
  • local irritation, high temps and emotional stress
  • Polyarthropathy syndrome, esp in adults, lasting 1-3 wks or longer
29
Q

diagnosis of Erythema Infectiosum
what would show in their lab results?

A
  1. clinical - “slapped cheeks”/lacy rash
  2. blood test - IgM-specific antibodies to parvovirus B19
30
Q

tx for Erythema Infectiosum

A
  1. mild - self-limiting
  2. Symptomatic relief
  3. IV immune globulin for immunocompromised patients and those with RBC disorders
31
Q

complications with Erythema Infectiosum

A
  1. suppress RBC production
    - transient aplastic crisis
    - chronic red cell aplasia
    - hydrops fetalis
    - congenital anemia
    more likely in pts with RBC problems
32
Q

prevention for Erythema Infectiosum

A
  1. be clean
  2. develop immunity after infection
    no vaccines
33
Q

incubation of Roseola Infantum

A

5-15 days

34
Q

transmission of Roseola Infantum

A

airborne
spring&fall

35
Q

HH-6 and -7 are prevalent in what demographic

A

healthy population
almost all children between 6 months - 3 yrs
rarely in >4yrs and <2yrs

36
Q

s/s of Roseola Infantum

A
  1. High fevers lasting 3-5 days
  2. blanchable, rosey pink, nonpruritic macular rash
    - predominantly on the neck and trunk
    - happens after fever

during fever = feels sick
rash appears = feels normal again

37
Q

diagnosis of Roseola Infantum? additional work up?

A
  1. clinical
  2. febrile seizure = seizure workup
38
Q

tx for Roseola Infantum

A

supportive - fluids, acetaminophen

39
Q

complications with Roseola Infantum

A

rare
meningitis, encephalitis, leukopenia, thrombocytopenia, hepatitis

40
Q

incubation of Varicella

A

10-21 days after exposure to chickenpox or shingles

41
Q

transmission of Varicella

A
  • Very contagious
  • Does not require skin-skin contact
  • Can be spread by someone who has shingles
42
Q

communicable period of Varicella

A

1-2 days before the rash appears until time all blisters have scabbed over

43
Q

pt with vesicles on an erythematous base = “dewdrop on a rosepetal” has what infection

A

varicella

44
Q

diagnosis of varicella

A
  1. PCR swab of lesion
  2. IgM titers
45
Q

tx for varicella

A
  1. Symptomatic
    - Calamine lotion / oatmeal baths
    - Trim nails
    - Acetaminophen
  2. Antivirals (high risk)
    - Acyclovir / valacyclovir
    - Started w/in 24 hours and treat 5 days
  3. Varicella immunoglobulin
    - High risk individuals
46
Q

CDC vax recommendations for varicella

A

2 doses
- age of 12–15 months
- at 4–6 years

47
Q

incubation of HFMD

A

3-7 d

48
Q

transmission of HFMD

A
  1. Highly contagious
  2. Nasal secretions, saliva, stool, blisters, resp droplets
  3. Summer and fall
49
Q

communicable period of HFMD

A

Most contagious first week of illness
can transmit until all blisters resolved

50
Q
  • A red non-pruritic rash, often with blistering (vesicles), on the palmar and plantar skin
  • Painful, red, blister-like lesions on the tongue, gums, hard palate, and buccal mucosa
    what is the diagnosis?
A

HFMD

51
Q

diagnosis and tx for HFMD

A
  1. clinically - Distinction from other viral infections by:
    - The age of the affected person
    - The pattern of signs and symptoms
    - The appearance of the rash or sores
  2. supportive
    - resolves 7-10 d
    - topical oral anesthetic
    - OTC pain medications
52
Q

complications with HFMD

A
  1. dehydration (MC)
  2. encephalitis
53
Q

prevention for HFMD

A

good hygiene

Infectious disease (15 decks)

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