Wk 4 Infectious Exanthems

Question 1

Warts
virus: 
transmission: 
incubation: 
communicability: 
Dx: 
management:

Answer 1

virus: human papilloma virus (HPV)
transmission: direct contact
incubation: 3 mo. - many years
communicability: when present
Dx: inspection, acetic acid
management: liquid N2, acids, lasers, surgery, immunization

Question 2

Molluscum Contaniousum
virus: 
transmission: 
incubation: 
communicability: 
Dx: 
management:

Answer 2

virus: poxvirus
transmission: direct contact
incubation: 2-7 wk (-6 mo.)
communicability: low
Dx: waxy, umbilicated lesions, smear and stain
management: central core mechanical removal, liquid N2, acids

Question 3

Variola (smallpox)
virus: 
transmission: 
incubation: 
communicability: 
Dx: 
management:

Answer 3

virus: poxvirus
transmission: direct contact
incubation: 12 days
communicability: lesions-crusts present
Dx: culture of lesions, serology
management: strict isolation, symptomatic Tx, active immunization and vaccinia Ig w/i 24 hr

Question 4

Ecthyma Contagiosum
virus: 
transmission: 
incubation: 
communicability: 
Dx: 
management:

Answer 4

virus: Orf virus (herpesvirus)
transmission: contact w/ sheep (spring)
incubation: 4-7 days
communicability: infected sheep
Dx: solitary, silver lesion on hand (erythematous–> vesicle)
management: 30-40 days spontaneous resolution

Question 5

Varciella (chickenpox)
virus: 
transmission: 
incubation: 
communicability: 
Dx: 
management:

Answer 5

virus: varicella-zoster
transmission: respiratory droplets, direct contact
incubation: 14-16 days
communicability: 2 days before rash–end of crusting
Dx: rash w/ macule–>vesicle formation in 24 hr, serology, immunofluorescent stain of lesion
management: acyclovir, X asprin

Question 6

Cold Sore, Genital Herpes, Whitlow
virus: 
transmission: 
incubation: 
communicability: 
Dx: 
management:

Answer 6

virus: HSV 1 and 2
transmission: direct contact, outbreak w/ stress
incubation: 2 days–2 wk, latent and recurrent
communicability: 1–several wk, not well defined
Dx: inspection
management: acyclovir

Question 7

Roseola
virus: 
transmission: 
incubation: 
communicability: 
Dx: 
management:

Answer 7

virus: Herpes virus 6 and 7
transmission: respiratory droplets
incubation: 9 days
communicability: during febrile stage
Dx: rash develops as fever clears, isolate virus
management: antipyretics, ganciclovir
often improperly cited as penicillin allergy

Question 8

Infectious mono
virus: 
transmission: 
incubation: 
communicability: 
Dx: 
management:

Answer 8

virus: Epstein-Barr (herpesvirus)
transmission: pharyngeal droplets
incubation: 30-50 days
communicability: months after recovery
Dx: post. cervical lymph nodes, tender and enlarged spleen, atypical lymphocytes, rapid mono test, heterophile antibody
management: X contact sports, X ampicillin, steroids, watch for jaundice

Question 9

Hand, Foot, and Mouth Disease
virus: 
transmission: 
incubation: 
communicability: 
Dx: 
management:

Answer 9

virus: Coxsackie virus A (or B)
transmission: respiratory droplets, fecal
incubation: 3-6 days
communicability: several weeks
Dx: viral serology, mucous membranes and feces
management: good sanitation

Question 10

Non-specific viral exanthem
virus: 
transmission: 
incubation: 
communicability: 
Dx: 
management:

Answer 10

virus: Echovirus (herpesvirus)
transmission: fecal–>oral (summer and early fall)
incubation: 3-6 days
communicability: several weeks during viral shedding
Dx: serology of feces
management: care w/ diaper changing

Question 11

Nonspecific respiratory virus w/ possible exanthem
virus: 
transmission: 
incubation: 
communicability: 
Dx: 
management:

Answer 11

virus: enterovirus D-68
transmission: respiratory secretions
incubation: 1-5 days
communicability: 1 day prior-5days after
Dx: PCR serology, possible episodes of extremity paralysis
management: admit w/ serious resp. Sx

Question 12

Fifth Disease
virus: 
transmission: 
incubation: 
communicability: 
Dx: 
management:

Answer 12

virus: human parvovirus B19
transmission: respiratory droplets
incubation: 4-14 days
communicability: shortly before and after rash
Dx: serology
management: XX pregnant women, spontaneous abortion in first trimester

Question 13

Measles (rubeola)
virus: 
transmission: 
incubation: 
communicability: 
Dx: 
management:

Answer 13

virus: paramyxovirus
transmission: direct contact, respiratory droplets (2-5 yr cycles in winter-spring)
incubation: 8-12 days
communicability: 5 days before-4 days after rash
Dx: rhinitis, cough, conjunctivitis, macropapular rash from trunk to extremities that becomes confluent, fever up to 104, Koplik’s spots
management: vitamin A, vaccination

Question 14

Rubella (German measles)
virus: 
transmission: 
incubation: 
communicability: 
Dx: 
management:

Answer 14

virus: Toga virus
transmission: respiratory droplets, direct contact (6-9 yr cycles, winter and spring)
incubation: 16-18 days
communicability: 7 days before-5 days after rash
Dx: suboccipital and post. auricular nodes, serum
management: isolation

Question 15

Dengue fever
virus: 
transmission: 
incubation: 
communicability: 
Dx: 
management:

Answer 15

virus: Dengue virus (arbovirus and Chikungunya virus)
transmission: mosquito borne, only around equator and not in winter months
incubation: 3-8 days
communicability: up to 70 days in mosquito
Dx: fever–>generalized maculopapular rash, not on palms or soles, arthralgias
management: mosquito screens