viral infections with exanthem exanthem is widespread rash with fever
Post on 04-Jan-2016
217 Views
Preview:
TRANSCRIPT
Viral infections with exanthemexanthem is widespread rash
with fever.
Measles(robeola)
•1-the incubation period 7-14 days•2-high fever is the first sign last 4-7 days
•3-prodromal phase :fever ,anorexia and classical triad of conjunctivitis cough and
coryza(3c),photophobia,periorbital edema and myalgia may occurred.
• 4 -the characteristic enanthem generally appears 2-4 days after the onset of the prodrome and last 3-5 days(koplik spots) can be seen inside
the cheeks during the early stage.it is pathognomonic but its absence does not exclude
the diagnosis .
• 4 -the characteristic enanthem generally appears 2-4 days after the onset of the prodrome and last 3-5
days(koplik spots) can be seen inside the cheeks during the early stage.it is pathognomonic but its absence does not exclude the diagnosis.it is defined
as grains of sound on a red base appeared on a buccal mucosa apposite
the second molars .
•5-the exanthema usually appears 1-2 days after the appearance of
koplik spots,the rash is maculopapular starting on face
and upper neck and spreading to the extremities ,the entire course
of uncomplicated measles from late prodrome to resolution of
fever and rash is 7-14 days.
complications•They are more common in adults especially
pregnant ,malnourished and immunocompromised patients:
•1-otitis media•2-bacterial pneumonia•3-Transient hepatitis•4-Encephalitis(0.1%)•Subacute sclerosing
panencephalitis(sspe)which is rare complication and late occurred after 7 years.
•Diagnosis is clinical and by detection of antibody (IgM) in serum or saliva or by PCR OR
VIRAL CULTURE.•Death occurred from bacterial
super infection as complication of measles :pneumonia,diarrhoea and gangrenous stomatitis or
encephalitis.
Management:•1-supportive in uncomplicated•2-immunoglobulin given to
immunocompromised patients may attenuate the disease if received
within 6 days.•3-vitamin A
•4-antibiotic is reserved for bacterial infection.
Prevention.
•MMR is lived attenuated vaccine that is contraindicated in
immunocompromised patients•If patient with TB it should be
deferred until completion of anti TB therapy.
•Measles give life long immunity .
Rubella(german measles)
1 -it spread by respiratory droplets.
2-infectivity from up to 10 days before to two weeks after rash.
3 -it usually sub clinical in adults.
Clinical features:
1 -fever2-maculopapular rash spreading from face .
3-lymphadenopathy.4 -in adults especially women arthritis is
relatively common ,this enter in differential diagnosis of undifferentiated arthritis the
most important of this is rheumatoid arthritis.
Congenital rubella.•Laboratory confirmation is required if there has
been contact with pregnant women because rubella virus had the potential for trans placental
transmission and severe congenital malformations occurred, this is achieved by detection of igM
against rubella in serum or by IgG seroconversion,in the exposed pregnant absence
of specific rubella igG confirm the potential for congenital infection.
•Congenital rubella is risk for diabetes mellitus .
prevention
•1 -all children should be immunized as for measles by
MMR.•2-all children of childbearing age
should be tested for rubella and vaccinated if seonegative.
top related