Viral Exanthems

Question 1

Measles (Rubeola)

Answer 1

Paramyxovirus

Rash:
Erythmatous maculopapular rash
Erupts 5 days after onset of prodromal symptoms
Begins on head and spreads to body
Lasting 4-5 days

Koplik spots (white spots on buccal mucosa)–>pathognomonic but leave before rash so often not found when patient presents

Dx: fever and Hx of 3 C’s: cough, coryza, conjunctivitis

Question 2

Rubella (German Measles)

Answer 2

Togavirus

Suboccipital lymphadenopathy

Rash:
Maculopapular rash begins on face then generalizes
Rash lasts 5 days, fever may accompany rash on first day only

May find reddish spots of various sizes on soft palate

Question 3

Roseola Infantum (Exanthum subitum)

Answer 3

HHV-6

ABRUPT HIGH FEVER persisting for 1-5 days even though child has no physical symptoms to account for fever and does not feel ill

Rash:
Appears when fever drops, macular or maculopapular rash appears on trunk and then spread peripherally over entire body, lasts 24 hrs

Question 4

Erythema infectious (Fifth Disease)

Answer 4

Parvovirus B19

“Slapped cheeks”

Rash:
erythematous maculopapular rash spreads from arms to trunk and legs, forming reticular pattern

Dangerous in sickle cell pts (and other anemias) b/c can cause aplastic crises

Caution re: exposure to pregnant mothers b/c of high risk of fetal complications