Science Quiz / Childhood Exanthems

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Can you name the Childhood Exanthems?

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A systemic infection, but with strong affinity for the salivary glands and the CNS. Endemic worldwide; most common in winter and spring.
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
CNS involvement, mainly as aseptic meningitis (10-15% of cases, mostly transient).
Virus infects erythroid precursors. Incubation period: 13-18 days.
Often involves an acute polyarthropathy
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
Eruptive lesions on the mucous membranes occurring as a symptom of a general disease
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
30% of cases are asymptomatic. Least communicable of the childhood diseases.
________ is a major sign of mumps.
Immunosuppression is marked by CD4 and CD8 lymphopenia (cause still unknown)
Herpesvirus Enveloped DNA viruses
A mild disease of children, but dangerous to the fetus during an intrauterine infection.
mostly associated with infection in immunocompromised adults, causing an abrupt onset of symptoms, with fever, malaise, encephalitis and other organ system involvement, especially
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
AKA “three day measles”. Erythematous, maculopapular rash. Begins on the face and moves caudad.
Pts with chronic anemias (i.e., sickle cell), may develop severe but self-limiting anemia (transient aplastic crisis).
Paramyxoviruses Enveloped RNA viruses
Within 24 to 48 hours of defervescence a faint pink maculopapular rash appears
Parvoviruses Non-enveloped ssDNA viruses
typically infects children < 2 yrs old. Accounts for up to 20% of visits to ERs for pediatric febrile illnesses.
Most commonly caused by Coxsackie A group viruses. Disease is mild, resolves in a week, and treatment is symptomatic only.
Infectious period begins 2 days before skin lesions appear and ends when the lesions crust
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 birth defect if Rubella is acquired by a pregnant woman.
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.
Typically affects unvaccinated children ages 1-6 yrs. 1-2 days: Low grade fever, malaise, abdominal pain, pruritis, cough, coryza, sore throat
Togaviruses Enveloped RNA viruses
Treatment: Supportive care. Treat complications. Vitamin A supplements have been shown to decrease mortality by 50%.
Usually start on trunk and spreads to face and extremities.
Systemic appearance contrasts with herpangina, which affects mouth 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.
Undifferentiated febrile illness. High fever lasting 3-5days.
maculopapular rash begins on the head and extends downward to involve the extremities and trunk. Rash is accompanied by high fever (104o F).
If severe fetal anemia develops, intrauterine transfusion can correct the anemia and reduce mortality.
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
Major prognostic signs of the prodromal period are the clustering of CCC&P (cough, coryza, conjunctivitis and photosensitivity), followed by diagnostic Koplik’s spots.
Associated with humoral and cell-mediated immune responses. Induces long-lasting immunity
Koplik spots are pathognomonic. Fever- 4 days. 3 C's - Cough, Coryza, Conjunctivitis.
***If pregnant female is infected, may cause fetal anemia leading to hydrops fetalis ***
About 20-50% of adult males will develop orchitis. Sterility is rare.
Causes a maculopapular, erythematous rash, lasting 3-5 days. Lymphadenopathy is prominent especially above the neck.
The most common viral cause of stillbirth
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.
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.
The rash is very intense on face and spreads to the trunk and arms.
Picornaviruses Non-enveloped RNA viruses
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.
Complications: Secondary bacterial infections of the skin, pneumonia, encephalitis.
Patients with chronic hemolytic anemias who develop aplastic crisis need to be treated for symptoms of anemia and may require blood transfusion
Treatment: Supportive only; acyclovir and ganciclovir are used prophylactically in stem cell transplant pts.
Name a classic childhood exanthem
A skin eruption (rash) occurring as a symptom of general disease
Forchheimer spots (pinpoint red macules on soft palate). Mild inflammation of pharynx and conjunctiva.

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Created Apr 13, 2012ReportNominate

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