Viral Exanthems Flashcards
What is Varicella?
Highly contagious intraepidermal vesicular eruption
What is Varicella caused by?
Varicella zoster virus
T/F: A 2-3 day prodrome of H/A, fever, malaise, sore throat, anorexia, & cough precedes pruritic vesicular eruption in Varicella
True
What does a Varicella rash look like?
What’s the buzzword?
- Polymorphic eruption of macules –> papules/vesicles/pustules –> necrosis, may be umbilicated
- “Dew drop on a rose petal” (vesicle with erythematous base)
T/F: Rubeola “Measles” is preceded by a prodrome and often generalized LAD
True
What are the 3 C’s of Rubeola “Measles”?
- Cough
- Coryza (rhinitis)
- Conjunctivitis
What does a Rubeola “Measles” rash look like?
What’s the distribution?
- Generalized erythematous maculopapular eruption
- Becomes confluent on head & trunk, remains discrete on extremities
- Starts behind ears –> trunk –> extremities
Prior to the rash seen in Rubeola “Measles” pts get?
Koplik spots: tiny gray-white papules on erythematous base on buccal mucosa
T/F Rubella “German Measles” is preceded by a prodrome and often strikingly large LN of the head & neck
True
Rubella “German Measles” is spread via?
Respiratory droplets
What does the rash in Rubella “German Measles” look like?
What’s the distribution?
- Maculopapular eruption
- Unlike Rubeola “Measles” lesions typically remain discrete in all areas and is less red/bright
- Red spots on soft palate
- Starts behind ears –> trunk –> extremities
Complications of Rubella “German Measles”?
- Arthritis
- Congenital Rubella Syndrome (in babies born to a mother who was infected in 1st trimester)
T/F: Roseola is preceded by a prodrome.
True
This is the m/c viral exanthem in kids <2 y/o
Roseola
Fever Fever Fever RASH
Roseola
What does the Roseola (HHV-6) rash look like?
Where is it m/c located?
How long does it last?
- Discrete rose/red macules & papules
- Trunk & proximal extremities
- 24-48 hrs
Complications of Roseola?
May cause febrile seizures newborns
How do you treat Roseola?
SUPPORTIVE -self limiting
What’s the causative agent for Erythema Infectiosum “5th Dz”?
Enterovirus (Parvo B19)
What does the rash in Erythema Infectiosum “5th Dz” look like?
- Confluent erythema on cheeks
- Lacy reticular erythema on rest of body
- May be pruritic
Slapped cheek appearance
Erythema Infectiosum “5th Dz”
Complications of Erythema Infectiosum “5th Dz”?
- Arthritis
- Acute aplastic crisis in pts with chronic hemolytic anemia (sickle cell)
How do you treat Erythema Infectiosum “5th Dz”?
Symptomatically
- Self limiting in young kids
- Need to be extra careful if pt is pregnant or has sickle cell
T/F: Coxsackie “Hand Foot Mouth” is preceded by a prodrome
Ture
What’s the causative agent for Coxsackie “Hand Foot Mouth”?
Coxsackie virus A-16
What does the rash in Coxsackie “Hand Foot Mouth” look like?
- Oral lesions that start as erythematous macules –> small vesicles on erythematous base –> ulcerate into painful lesions
- Similar lesions on hands and feet
How is Coxsackie “Hand Foot Mouth” treated?
SYMPTOMATIC
- Magic mouthwash (mylanta, benadryl, & viscous lidocaine)
What is Kawasaki Disease “Mucocutaneous LN Syndrome”? What’s it characterized by?
Acute febrille illness of early childhood characterized by vasculitis of the medium-sized arteries
T/F: Kawasaki is typically self-limiting
True
What’re S&S of Kawasaki?
- Fever
- Bilateral nonexudative conjunctivitis
- Erythema of lips & oral mucosa + dry/cracked lips
- Rash
- Edema of hands/feet
- Cervical LAD
- +/- Peeling
Complications of Kawasaki?
- Coronary artery aneurysms
- Depressed myocardial contractility & HF
- MI
- Arrhythmias
- Peripheral arterial occlusion
This is a leading cause of aquired heart disease in the US
Kawasaki Disease
When is Kawasaki m/c?
Who is typically affected?
- M/C in winter & spring
- Kids 5/yo, M >F
How is Kawasaki Disease treated?
IVIG & Aspirin
What is the diagnostic criteria for Kawasaki. disease?
Presence of fever for at least 5 days + at least 4/5 of the following criteria:
1. B/L bulbar conjunctival injection
2. Oral mucous membrane changes
3. Peripheral extremity changes
4. Polymorphous rash
5. Cervical LAD
