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 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 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, 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