Science Quiz / Childhood Exanthems

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Can you name the Childhood Exanthems?

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Herpesvirus Enveloped DNA viruses
Infectious period begins 2 days before skin lesions appear and ends when the lesions crust
Begins with the classic slapped-cheek appearance. 1-4 days after malar rash, an erythematous macular-to-morbilliform eruption occurs primarily on the extremities. Fades into a lacy
If severe fetal anemia develops, intrauterine transfusion can correct the anemia and reduce mortality.
Complications: Hospitalization in 18% of patients. Pneumonia in 6% of children and 5-30% of adults. Otitis media in 7-9% of patients. Death is 1-3 per 1000 cases.
A mild disease of children, but dangerous to the fetus during an intrauterine infection.
Complications: Secondary bacterial infections of the skin, pneumonia, encephalitis.
Often involves an acute polyarthropathy
30% of cases are asymptomatic. Least communicable of the childhood diseases.
A systemic infection, but with strong affinity for the salivary glands and the CNS. Endemic worldwide; most common in winter and spring.
Major prognostic signs of the prodromal period are the clustering of CCC&P (cough, coryza, conjunctivitis and photosensitivity), followed by diagnostic Koplik’s spots.
Treatment: Supportive care. Treat complications. Vitamin A supplements have been shown to decrease mortality by 50%.
Common cause of febrile illness in children (AKA exanthem subitum, “sudden rash”). Rarely affects healthy adults, in which it causes a mild mono-like illness
Causes a maculopapular, erythematous rash, lasting 3-5 days. Lymphadenopathy is prominent especially above the neck.
Paramyxoviruses Enveloped RNA viruses
Parvoviruses Non-enveloped ssDNA viruses
About 20-50% of adult males will develop orchitis. Sterility is rare.
Incubation period 6-15 days. Symptoms include sudden severe fever (103-105o F), lasting 3-5 days, malaise, irritability, signs of URT infection. 10-30% of pts develop a maculopapul
infection has been associated with “gloves and socks” syndrome: a papular, purpuric eruptions manifesting as a painful rash and swelling in the hands and feet.
Usually start on trunk and spreads to face and extremities.
Immunosuppression is marked by CD4 and CD8 lymphopenia (cause still unknown)
Name a birth defect if Rubella is acquired by a pregnant woman.
Picornaviruses Non-enveloped RNA viruses
Typically affects unvaccinated children ages 1-6 yrs. 1-2 days: Low grade fever, malaise, abdominal pain, pruritis, cough, coryza, sore throat
Pts with chronic anemias (i.e., sickle cell), may develop severe but self-limiting anemia (transient aplastic crisis).
The most common complications in post-pubertal women (50% of pts) are arthropathies of the fingers, wrists, and knees that persist for up to a month [one of the few viral arthritid
Togaviruses Enveloped RNA viruses
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Forchheimer spots (pinpoint red macules on soft palate). Mild inflammation of pharynx and conjunctiva.
Treatment: Supportive only; acyclovir and ganciclovir are used prophylactically in stem cell transplant pts.
Patients with chronic hemolytic anemias who develop aplastic crisis need to be treated for symptoms of anemia and may require blood transfusion
typically infects children < 2 yrs old. Accounts for up to 20% of visits to ERs for pediatric febrile illnesses.
Associated with humoral and cell-mediated immune responses. Induces long-lasting immunity
In immunosuppressed pts or in infants less than 1yo, persistent infection can develop and cause a serious prolonged chronic anemia owing to persistent lysis of RBC precursors.
***If pregnant female is infected, may cause fetal anemia leading to hydrops fetalis ***
A skin eruption (rash) occurring as a symptom of general disease
mostly associated with infection in immunocompromised adults, causing an abrupt onset of symptoms, with fever, malaise, encephalitis and other organ system involvement, especially
60% of adult pts, esp. middle-aged women and adolescents, may have arthralgia (esp. hands, knees, wrists, ankles). Arthropathy may be the only clinical manifestation of infection.
Fetuses are at risk (~1.5-2.5%) for severe anemia, generalized edema and possible myocarditis, leading to congestive cardiac failure (hydrops fetalis), and fetal death if a seroneg
Within 24 to 48 hours of defervescence a faint pink maculopapular rash appears
CNS involvement, mainly as aseptic meningitis (10-15% of cases, mostly transient).
Undifferentiated febrile illness. High fever lasting 3-5days.
AKA “three day measles”. Erythematous, maculopapular rash. Begins on the face and moves caudad.
Most commonly caused by Coxsackie A group viruses. Disease is mild, resolves in a week, and treatment is symptomatic only.
Each lesion starts as a red macule and passes through stages of papule, vesicle, pustule, and crust. Lesions appear in crops. Hallmark is the presence of lesions in various stages.
Eruptive lesions on the mucous membranes occurring as a symptom of a general disease
Systemic appearance contrasts with herpangina, which affects mouth only.
Koplik spots are pathognomonic. Fever- 4 days. 3 C's - Cough, Coryza, Conjunctivitis.
________ is a major sign of mumps.
Virus infects erythroid precursors. Incubation period: 13-18 days.
maculopapular rash begins on the head and extends downward to involve the extremities and trunk. Rash is accompanied by high fever (104o F).
The rash is very intense on face and spreads to the trunk and arms.
Common acute illness, affecting mostly children, which is characterized by mild fever, anorexia, malaise, and tender vesicular lesions first appearing on the the hard palate, tongu
Name a classic childhood exanthem
The most common viral cause of stillbirth

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