Science Quiz / Childhood Exanthems

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QUIZ: Can you name the Childhood Exanthems?

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

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