Exanthematous Fever

Posted by e-Medical PPT Wednesday, February 29, 2012
Etiology
Infectious causes
 Virus:
 Classic viral exanthem: Measles, Rubella, VZV, Parvovirus, Roseola
 Others:, HSV, EBV, HBV, Enterovirus, Dengue
 Bacteria: Scarlet fever, Staph infection (sepsis, 4S,toxic shock syndrome), Meningococcemia, typhoid
 Mycoplasma
 Rickettsial infection
Noninfectious cause
 Allergy: Food, drug, toxin, serum sickness
 Uncertain cause: Kawasaki disease

Measles
Clinical Manifestation
Incubation: 8-12 days, the average interval between appearance of rash in the source case and subsequent cases is 14 days, with a range of 7-18 days.
Prodromal period: fever 2-4 day + 3C
 cough
 coryza
 conjunctivitis
 Koplik spot
Rash: erythematous maculopapular rash
 facesole in 72 hr.
 face and trunk: mostly distributed
 pneumonia
Convalescence
 cough may persist for 1 week

Complications
Pneumonia
Otitis media
Diarrhea
Meningoencephalitis
Croup
Subacute sclerosing panencephalitis (SSPE)

Rubella
Clinical Manifestation
Prodromal period 1-5 days
Macularpapular rash for < 3 days
LN at postauricular and cervical area
CBC: normal range
Dx: viral isolation
Serologic test: CF, HI, IgM ELISA

Complications
arthritis
thrombocytopenia
meningoencephalitis
Treatment: supportive
Isolation:
  droplet precaution for 7 days after onset of rash,
  contact precaution for congenital rubella until > 1 yr-old
Prevention: immunization

Chickenpox
Clinical Manifestation
Prodromal period: 2-3 days
Generalized, pruritic, vesicular rash 250-500 lesions involving skin and oral mucosa
Complications
 Herpes Zoster, Shingles
 Congenital varicella: Scar, limb, ocular, CNS defect
 Bacterial infection
 Severe chickenpox
 CNS: encephalitis, cerebellar ataxia, Reye’s Syndrome...

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