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Pediatrics > Viral Rashes > Flashcards

Viral Rashes Flashcards

1
Q

Erythema Infectiosum

  • aka
  • virus
  • incubation
A
  • fifths disease
  • parvovirus B19
  • 1-2 weeks, up to 3 weeks
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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
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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
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4
Q

Erythema Infectiosum

- tx

A

supportive

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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
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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
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7
Q

Mumps

- sx

A
  • fever
  • ha
  • myalgia
  • fatigue
  • anorexia
  • within 48 hours partotis (significant)
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8
Q

Mumps

- dx

A
  • positive serum mumps IgM antibody

- mumps RNA via RT-PCR (buccal or oral swab)

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9
Q

Mumps

- prevention

A
  • vaccination

- 2 dose series, can give 3rd during outbreak bc immunity can wane

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10
Q

Mumps

- complications

A
  • orchitis or oophoritis

- neuro: meningitis, encephalitis, deafness

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11
Q

Roseola Infantum

  • aka
  • virus
  • age prevalence
A
  • sixth dz, three day fever, etc.
  • HHV 6
  • peak prevalence 7-13 months
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12
Q

Roseola Infantum

- sx

A
  • 3 to 5 days high fever (>104!) that resolves abruptly

- rash follows fever

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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!
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14
Q

Roseola Infantum

- transmission

A
  • asx shedding of virus in secretions of close contacts

- might shed lifelong!!

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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
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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
Q

Rubeola (measles)

- dx

A
    • reportable disease
  • suspect if: febrile rash with clinical sx
  • serology: anti-measles IgM
26
Q

Rubeola (measles)

- tx

A
  • supportive
  • Vitamin A
  • ribavirin
27
Q

Rubeola (measles)

- complications

A
  • secondary infections
  • diarrhea, other GI
  • pneumonia MC cause of measles-associated death
  • encephalitis
  • keratitis, corneal ulceration
28
Q

Rubeola (measles)

- complications in pregnant women

A
  • low birthweight
  • spont abortion
  • intrauterine fetal death
  • maternal death
29
Q

Rubeola (measles)

- prevention

A
  • 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
Q

Varicella

  • virus
  • transmission
A
  • varicella zoster
  • aerosolized droplets from nasopharyngeal secretions
  • direct cutaneous contact with vesicle fluid from skin lesion
31
Q

Varicella

- sx

A
  • 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
Q

Varicella

- complications

A
  • 2nd skin infection

- encephalitis, reye syndrome

33
Q

Varicella

- tx

A
  • supportive

- high risk for complications: antiviral therapy (acyclovir)

34
Q

Hand, Foot, Mouth disease

  • virus
  • transmission
A
  • 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
Q

Hand, Foot, Mouth disease

- sx

A
  • 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
Q

Hand, Foot, Mouth disease

  • dx
  • tx
A
  • dx: clincial
  • Tx: supportive
  • warn of peeling nails
37
Q

Hand, Foot, Mouth disease

- prevention

A
  • hand hygiene, surface cleaning

- don’t need to exclude from daycare, will shed when asx…

38
Q

Hand, Foot, Mouth disease

- complications

A
  • rare: encephalitis, myocarditis, meningitis, flaccid paralysis
  • dehydration due to mouth pain MC

Pediatrics (9 decks)

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