Rubella (German Measles): The Daily PANCE Blueprint

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Rubella (German Measles): The Daily PANCE Blueprint

A 22-year-old college student presents to the clinic with a 3-day history of low-grade fever, sore throat, and generalized lymphadenopathy. The patient also notes a fine, pink rash that started on the face and spread to the trunk. There is no history of recent travel or known sick contacts. Given the clinical presentation, you consider both Epstein-Barr virus (EBV) infection and rubella as potential diagnoses. Which of the following findings would most strongly suggest the diagnosis is rubella rather than EBV?

A. Heterophile antibody test positive
B. Presence of Forchheimer spots
C. Splenomegaly on physical examination
D. Severe pharyngitis with exudates
E. Elevated liver enzymes

Answer and topic summary

The answer is B. Presence of Forchheimer spots

Presence of Forchheimer spots, small, red spots seen on the soft palate, are more characteristic of rubella than EBV infection. While both conditions can present with rash and lymphadenopathy, Forchheimer spots provide a distinguishing feature that leans towards rubella.

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Covered under ⇒ PANCE Blueprint Infectious Disease ⇒ Viral Infectious Disease ⇒ Rubella (German Measles)

Also covered as part of the Pediatric EOR topic list