Science Quiz / Childhood Exanthems

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Can you name the Childhood Exanthems?

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

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