Exanthematous diseases
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| why is the history important? | many viral exanthems look similar, so a diagnosis is difficult without a corresponding history!
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| caused by a single strande dRNA virus in the family of paramyxoviridae. enters nasoendothelium and spreads and multiplies by reticuloendothelial system. presents with fever and three C's: cough, coryza (runny nose), conjunctivitis | Rubeola (measles)
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| incubation phase of measles? | 10 to 12 days with litlte to no sign of illness
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| prodromal phase length of measles? | 3-5 days of cough, coryza, conjunctivitis, koplik spots, high fever.
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| final stage of measles? | final stage: maculopapular eruption in a head to toe distribution as the fever is resolving.
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| gray white papules of the buccal mucosa in a patient with rubella | koplik spots
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| has a resurgence of measles occured in the 1960s? | yes. cases in 2013 as well.
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| measles complications? | pneumonia, bronchitis, otitis media, gastroenteritis, myocarditis, and encephalitis, neurologic complications.
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| main complications of measles? | neurologic complications are more common than in any other exanthematous illness.
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| prevention of measles? | MMR vaccine combination give an 12 months and 4-6 years.
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| another name for Rubella? | german measles, 3 day measles.
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| caused by RNA virus from familiy of togaviridae. clinically milder than measles wit ha prodrome of low grade fever, headache, rhinorrhea, malaise, myalgias, sore throat, lymphadenopathy, and cough 2-5 days before the exanthem appers. | rubella
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| skin findings of rubella? | erythematous to "rose pink" macules and papules that become confluent presenting in a cephalocaudal manner.
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| what is a major goal of rubella immunization (available as MMR combination vaccine)? | to prevent spread to pregnant women. fetal infectoin may lead to miscarriage, stillbirth, and/or congenital rubella syndrome.
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| erythema infectiosum (fifth disease) is caused by... | parvovirus B19 (DNA virus).
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| fifth disease most prevalent in... | school aged children. spread through respiratory droplet. may occur ear round but most common in late winter and spring.
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| erythema infectiosum prodrome? | low grade fever, headache, and URI symptoms (infectious stage)
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| describe the 3 stages of rash in erythema infectiosum | 1. facial flushing ("slapped cheeks") appearance. 2. trunk and proximal extremities are quickly covered in a diffuse, macular erythema. central clearing of eruption gives a lacy, reticulated apperarance. 3. may wax and wane over 1-3 weeks.
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| in erythema infectiosum, which areas are spared? | palms and soles of feet
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| caused by HHV6 or 7-herpesviridae family. DNA virus preferentially infected activated T cells enhancing natural killer cell activity and induction of numerous cytokines. may become latent following primary infection ad reactivate during altered immunity. | roseola infantum (sixth disease)
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| peak incidence of sixth disease? | between 6 and 12 months.
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| roseol ainfantum clinical manifestations? | 3-5 days of high fiver (101-106), inicial absence o fphysical findings sufficient to explain the degree of fever. as fever resolves, the rash appears on teh trunk and then spreads to limbs and face. erythematous, blanchable macules and papules
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| when does the rash dissolve in roseola? | 1-3 days
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| caused by herpes virus family. spread by respiratory dorplets or direct contact iwth lesions, incubation period 10-21 days. clinical manifest: primary disease: prodrome of fever, chills, malaise, headache, myalgias, and arthralgies 24 to 48 hours before | varicella (chicken pox). rash starts as red macule or papule that progresses to the vesicular stage- classically the "dew drop on a rose petal"
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| what is one characteristic of chickenpox? | the simultaneous presence of lesions in various stages of evolution
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| when is the vaccine for chickenpox given | 12 months and 4-6 years. has resulted in a decline of varicella related infections and hospitalizations
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| enteroviral (picornavirus-RNA virus) exanthem, coxsackievirus A or B (fecal oral spread). summer and fall seasonal presentation, presents with fever, malaise, and a characteristic exanthem at the same time. | hand foot and mouth disease
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| in hand foot and mouth disease, where do grey white vesicular lesions appear? | on palms of hand and dorsum of feet, maculopapular eruption on the buttocks. there are also vesicles and erosions on the tongue, palate, buccal mucosa, and anterior tonsillar pillars
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| in hand foot and mouth disease, painful erosions and vesicle sin the mouth may lead to... | anorexia and dehydration
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