Viral Rashes Flashcards
1
Q
Erythema Infectiosum
- aka
- virus
- incubation
A
- fifths disease
- parvovirus B19
- 1-2 weeks, up to 3 weeks
2
Q
Erythema Infectiosum
- describe
A
- prodrome: fever, coryza, HA, nausea, diarrhea
- Rash: 2-5 d after prodrome.
- erythematous molar rash with relative circumoral pallor
- several days later, reticulated rash on trunks and extremities
3
Q
Erythema Infectiosum
- Dx
A
- Labs only if arthralgia of unknown cause or immunocompromised
- can detect parvovirus B19-specific IgM w/in 7-1 days of virus exposure
4
Q
Erythema Infectiosum
- tx
A
supportive
5
Q
Erythema Infectiosum
- complications
A
- Gianotti-Crosti syndrome: paulovesicular acrodermatitis with severe pruritis
- papular-purpuric “gloves and socks” syndrome: pruritus painful aural erythema w/ fever and mucosal lesions
6
Q
Mumps
- transmission
- MC age
- incubation
A
- respiratory droplets, direct contact, fomites
- 2-9 yo in crowded closed environment
- 16-18 days to onset of sx.
- infectious from 2d before to 5d after parotitis
7
Q
Mumps
- sx
A
- fever
- ha
- myalgia
- fatigue
- anorexia
- within 48 hours partotis (significant)
8
Q
Mumps
- dx
A
- positive serum mumps IgM antibody
- mumps RNA via RT-PCR (buccal or oral swab)
9
Q
Mumps
- prevention
A
- vaccination
- 2 dose series, can give 3rd during outbreak bc immunity can wane
10
Q
Mumps
- complications
A
- orchitis or oophoritis
- neuro: meningitis, encephalitis, deafness
11
Q
Roseola Infantum
- aka
- virus
- age prevalence
A
- sixth dz, three day fever, etc.
- HHV 6
- peak prevalence 7-13 months
12
Q
Roseola Infantum
- sx
A
- 3 to 5 days high fever (>104!) that resolves abruptly
- rash follows fever
13
Q
Roseola Infantum
- pathogenesis
A
- Ag on day 2, gone by day 7
- Ab on day 3
- Rash likely from Ab-Ag complex formation!
14
Q
Roseola Infantum
- transmission
A
- asx shedding of virus in secretions of close contacts
- might shed lifelong!!
15
Q
Roseola Infantum
- febrile phase sx
A
- malaise
- palpebral conjunctivitis
- edematous eyelids
- inflammation of tympanic membrane (otitis media??)
- uvulopalatoglossal junctional macules or ulcers
- URI sx
- lymphadenopathy
- less common: cough, vomit, bulging fontanelle
16
Q
Roseola Infantum
- Rash sx
A
- blanching macular or maculopapular rash X 1-2 days, can be 2-4 hours
- starts on neck, spreads to face and extremities
- usu non-pruritic, sometimes vesicular
- often interpreted as drug allergy!!
17
Q
Roseola Infantum
- dx
A
- clinical
- labs rarely needed unless want to rule out something else like UTI or strep
18
Q
Rubella
- virus
- ages affected
- transmission
A
- Rubella virus (rotavirus family)
- all ages
- Incubation 14-18 days
- droplet transmission, worse if close/prolonged contact
19
Q
Rubella
- sx
A
- rash is pinpoint pink maculopapules, spreads rapidly from face to trunk to extremities
- generalized rash within 24 hours, lasts 3 days
- lymphadenopathy (post auricular, post cervical, occipital)
- mild nonexudative conjunctivitis
- soft palate petechiae
- worse in older
20
Q
Rubella
- what sx is common in teens and adult women?
A
- arthralgia and arthritis
- last up to 1 month
21
Q
Rubella
- complications
A
- congenital rubella syndrome: hearing loss, mental retardation, CV defect, ocular defects
- encephalitis, bleeding complications (rare)
22
Q
Rubella
- prevention
A
- vaccine
- droplet precaution
- exclusion from school for 7d after rash onset
23
Q
Rubeola (measles)
- transmission
A
- very contagious
- respiratory droplets
24
Q
Rubeola (measles)
- sx
A
- prodrome: fever, malaise, cough, coryza, conjunctivitis ***
- Koplik’s spots: grainof salt on red base in mouth
- Exanthem: 6-7days, erythematous, maculopapular, blanching rash. Classically starts on face and spreads cephalocaudally and centrifugally, often spares palms and soles
- recovery: cough can last 1-2 weeks after rash
25
Rubeola (measles)
| - dx
* * reportable disease
- suspect if: febrile rash with clinical sx
- serology: anti-measles IgM
26
Rubeola (measles)
| - tx
- supportive
- Vitamin A
- ribavirin
27
Rubeola (measles)
| - complications
- secondary infections
- diarrhea, other GI
- pneumonia MC cause of measles-associated death
- encephalitis
- keratitis, corneal ulceration
28
Rubeola (measles)
| - complications in pregnant women
- low birthweight
- spont abortion
- intrauterine fetal death
- maternal death
29
Rubeola (measles)
| - prevention
- exposed ppl excluded from work from day 5-21 after exposure
- confirmed dx should stay home until 4d after rash appears
- staff: respirators, keep pts separate, don't reuse room for 2 hours after pt seen (droplets remain airborne that long)
30
Varicella
- virus
- transmission
- varicella zoster
- aerosolized droplets from nasopharyngeal secretions
- direct cutaneous contact with vesicle fluid from skin lesion
31
Varicella
| - sx
- mild and self limited in childhood, worse in older
- prodrome: fever, malaise, pharyngitis, loss of appetite
- Exanthem: generalized vesicular rash, usu appears in 24 hours. Usually pruritic, appears in crops
- macule > papule > vesicle > crust
32
Varicella
| - complications
- 2nd skin infection
| - encephalitis, reye syndrome
33
Varicella
| - tx
- supportive
| - high risk for complications: antiviral therapy (acyclovir)
34
Hand, Foot, Mouth disease
- virus
- transmission
- Coxsackievirus A16 (>15 serotypes)
- also cause Herpangina
- oral ingestion of virus shed from GI or UR tract
- stool viral shedding lasts 6 weeks, oropharynx lasts 4 weeks
- usu children <5-7 yo
35
Hand, Foot, Mouth disease
| - sx
- mouth or throat pain, refusal to eat
- if present, fever <101
- enathem: macules > vesicles > ulcers
- exanthem: macules, maculopapules, or vesicles or all
- includes palms, soles, personal, diaper region
36
Hand, Foot, Mouth disease
- dx
- tx
- dx: clincial
- Tx: supportive
- warn of peeling nails
37
Hand, Foot, Mouth disease
| - prevention
- hand hygiene, surface cleaning
| - don't need to exclude from daycare, will shed when asx...
38
Hand, Foot, Mouth disease
| - complications
- rare: encephalitis, myocarditis, meningitis, flaccid paralysis
- dehydration due to mouth pain MC
