Escolar Documentos
Profissional Documentos
Cultura Documentos
Viral Infections
are associated
with rash
(a skin eruption
occurring as a sx
of an acute
illness)
2.
"Fifth Disease"
Erythema
Infectiousum Parvo B19
3.
4.
"Sixth Disease"
Exanthema
Subitum - HHV6
/ Roseloa
IMMUNIZATION
Case 1
4 month old infant. No recent illness
or symptoms except one day of fever
yesterday
Up to date on childhood
immunizations. Non-itchy red
bumps trunk, no fever. ("Afebrile
with non-pruritic erythematous
maculopapular lesions")
Roseola
- high fever, rash
after fever, not
"ill"
Pathophysiology of Roseola?
- dsDNA virus
herpes family
- Incubation 5-15
days
- 85-90% adults
shed virus and
give it to kid
11.
12.
13.
5.
6.
7.
14.
15.
16.
17.
18.
8.
9.
10.
Case 2
3-year-old healthy girl. Initially rash
on cheeks, now also on trunk and
arms. Did have a cold / flu prior
week, now resolved. Flushed
appearance on cheeks "slapped
cheek" & flat lacy red rash on trunk
and arms.
- Erythema
Infectiousum
- Incubation
period: 4-14 days
- Infectious
during viremia
(fever, before
rash)
19.
- Pre-natal:
Hydrops fetalis
(fetus stops
making RBCs)
- Polyarthropathy
syndrome,
transient aplastic
crisis, persistent
anemia
Case 3
3 year-old with rash. 5 days cough,
red eyes, nasal congestion. Diffuse
morbilliform rash with antecubital
petechiae. Mild cough with bibasilar
lung crackles, & buccal white spots.
Rubeola
Measles
- Prodromal fever
- Cough, Coryza
(runny nose),
Conjunctivitis
- Koplik spots (in
mouth)
Case 4
Previously healthy 15 year-old male.
New onset diffuse red rash. Fever
started 2-3 days ago. Sore bumps
behind his earsstarted 7-10 days ago.
Rubella
German Measles
- Incubation 5-7
days after
exposure
- Preceded by
non-specific flu
- Accompanied by
lymphadenopathy
20.
21.
22.
23.
24.
25.
26.
- 85% effected
in 1st trimester
- Rare defects
after 20th week
of gestation
- Defects:
Deafness,
Catarracts,
glaucoma,
Valve abnl
Ment. Retard.
& microceph,
Later diabetes
- Still born
baby,
BLUEBERRY
MUFFIN
Case 5
Girl with blister-like rash. Preceded by
several days of flu with fever & body
aches. Rash started on face then spread
to body. Rash started as red spots that
became bumps and then filled with
fluid.
Variola
Small Pox
- 1 to 2 weeks
incubation
- Rash
preceded by few
days of "flu"
- Vesicles
appear in
SAME stages of
progression (vs
chicken pox)
Flat &
hemorrhagic
types = 100%
fatality rates
Generally 1/10
mortality rate.
Requires
STRICT
QUARANTINE
from onset
fever &
Vaccinate all
contacts
Case 6
Young immigrant male. Patient
uncertain about personal history of
childhood illnesses or vaccinations.
New onset of blister-like rash,
associated with fever. Non-specific
"flu" ~ 1-2 weeks prior.
Varicella
The rash is
crusted
29.
- Rash
preceded by
non-specific
"flu"
- Vesicles
appear in
DIFFERENT
STAGES of
progression (
vs small pox same stage)
30.
Varicella
- Before 20
weeks ->2-8%
congenital
malformations
- 28 wks - more
than 5d before
delivery -->
Infant
unaffected
- 5d before - 2d
after delivery ->
can be fatal
27.
28.
31.