|Erythema infectiosum (fifth disease)||
Erythema infectiosum (also known as Fifth's disease) is a common viral exanthem observed in pediatric patients caused by parvovirus B19
DX: is based primarily on clinical observations, history, and physical exam
TX: Treatment is symptomatic
Patient will present as → a 2-year-old who is brought to the office by his mother. The child has had a low-grade fever, rash, and loss of appetite for the past two days. On physical exam, there are multiple 2-3-mm grey vesicular lesions on the bilateral palms and soles and several vesicles and ulcers on the oral mucosa. The physician assistant informs her parents that this disease typically resolves spontaneously and to keep the patient hydrated.
DX: based primarily on clinical observations, history, and physical exam
TX: supportive, anti-inflammatories
The 4 C's - c ough, c oryza, c onjunctivitis, and c ephalocaudal spread
Measles (Rubeola) is caused by a paramyxovirus and is transmitted by respiratory droplets, it has a 10-12 day incubation period. It progresses in three phases characterized by a prodrome, enanthem, and exanthem
DX: Clinical diagnosis of measles requires a history of fever of at least three days, with at least one of the three C's (cough, coryza, conjunctivitis)
TX: Treatment is supportive - anti-inflammatories, isolate for 1 week after onset of rash
|Rubella (German measles)||
"3-day rash" ⇒ pink light-red spotted maculopapular rash first appears on the face, spreads caudally to the trunk and extremities, and becomes generalized within 24 hours (lasts 3 days)
DX: detection of rubella-specific immunoglobulin M or G
TX: supportive care ⇒ no specific therapy for rubella infection is available
|Roseola (sixth disease)||
Also known as exanthema subitum, caused by Herpesvirus 6 or 7 - only childhood exanthem that starts on the trunk ⇒ spreads to the face
DX: The diagnosis is clinical
TX: Treatment is supportive and in most cases, roseola is a benign and self-limited disease
Usually presents with fever, lymphadenopathy and fine maculopapular rash.
Typically presents with maculopapular rash with fever, conjunctivitis, cough, coryza.
Presents with pruritic rash that starts as erythematous maculopapular rash that become vesicles.
Rubella (German measles)
Presents with pruritic rash that starts as erythematous macules that become vesicles and later pustules.
Presents as fever, pharyngitis, and lymphadenopathy.
Presents as maculopapular rash with fever, conjunctivitis, cough, coryza.
Maternal rubella infection
Maternal varicella infection
Allergies to eggs or neomycin are not contraindications to the measles vaccine
Those who received killed virus immunization between 1963 and 1967 should receive a live attenuated booster vaccination
Infants receiving vaccination before 15 months of age do not need booster vaccinations
The present immunization is a genetically derived recombinant vaccine
Those born before 1956 should receive a measles booster vaccination
- Coxsackievirus A
- A16 is responsible for hand, foot, and mouth disease, which is characterized by stomatitis and a vesicular rash that affects the hands and feet. It is usually mild, affects young children, and may occur in epidemics.
- A2, A4, A5, A6, A7, and A10 are responsible for herpangina, which is a more severe febrile illness that sometimes leads to febrile seizures. Other symptoms include a severe sore throat; vesiculoulcerative lesions that affect the tonsils, soft palate, and posterior pharynx; headaches; myalgias; and vomiting.
- Coxsackievirus B
- B1, B2, B3, B4, and B5 are responsible for pleurodynia with pain associated with the area of diaphragmatic attachment. Other symptoms include fever, headache, sore throat, malaise, and vomiting. Orchitis and pleurisy may also occur.