Transcript Fevers and Rash

Sohil Rangwala
What could it be?
Varicella
 VZV virus
 Usually less than 10 years of age
 Significant decrease in incidence since vaccine
 Spread by droplets or open sores
 Fever, malaise, diarrhea, URI sx
 10-21 incubation
 Symptomatic treatment
Rare..but it happens!
Measles
 Highly contagious
 fever, conjunctivitis , cough, coryza and characteristic
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Koplik spots (small white spots in the mouth)
Between day 3 and 7 red blotchy rash.
non-itchy rash begins on face and behind the ears.
Within 24-36 hours it spreads to the entire trunk and
extremities
No treatment- but immunize!
Complications: OM, Pneumonia, glomerulonephritis,
SSPE
Rubella(German Measles)
 Very rare
 Spread through direct contact with nasal or throat
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secretions
Only significant if pregnant
Slight fever, sore throat, runny nose and malaise
Then begins on the face that spreads to the neck,
trunk and extremities
Appear as pink or light red spots about 2-3mm in size
No treatment- worry is congenital rubella!
Congenital Rubella is major concern
Roesola
 Caused by HHV 6 and HHV 7
 characterised by high fever lasting for 3-5 days, runny
nose, irritability and tiredness. As the fever subsides,
rash appears on the face and body.
 Most common 6mos to 3 years
• Typically small pink or red raised spots (2-5 mm in
diameter) that blanch when touched
• Starts on trunk and may spread to involve the neck, face,
arms and legs
• No specific treatment
Parvovirus B19 (Fifth’s disease)
 first sign of fifth disease is firm red cheeks, which feel
burning hot. A rash follows 1 to 4 days later with a lace
or network pattern on the limbs and then the trunk
 Can have slight fever, uri and headache as prodrome
 Once rash develops, no longer infectious
 Concern if exposure during pregnancy
 No specific treatment
Scarlet Fever
 mostly in children aged 4-8 years
 GAS is main culprit
 sudden fever, sore throat, swollen neck glands, headache,
nausea, vomiting, loss of appetite, swollen and red
strawberry tongue, abdominal pain, body aches, and
malaise
 rash appears 12-48 hours after the start of the fever and
starts below the ears, neck, chest, armpits and groin before
spreading to the rest of the body over 24 hours
 Sandpaper appearance
 Treatment: treat GAS!
Meningitis=BAD
 caused by Neisseria meningitidis
 fever, headahces, stiff neck, nausea, vomiting,
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decreased feeds
Petechiae (rash of small red or purple spots that do
not disappear when pressure is applied to the skin)
occur in 50-75% of cases
Rash may progress to larger red patches or purple
lesions (similar to bruises)
In severe cases lesions may burst and lead to necrosis
Early recognition is key!
References
 http://www.dermnetnz.org/viral/viral-exanthem.html
 www. Utdol.com