Viral Exanthem, Vaccine-Preventable Diseases Flashcards

1
Q
A

Gianotti-Crosti syndrome (flat-top red papules)

a/w HBV, EBV, CMV, enterovirus infections

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2
Q
  1. prodrome
  2. self-limiting slapped cheek syndrome (over malar areas)
  3. followed by fine lact maculopapular rash trunk/limbs + symmetrical small joint arthralgia/arthritis
A

Erythema infectiosum (5th disease) d/t parvo B19

no longer infectious once facial rash resolves (when Ab production occurs)

Dx: serology - IgM w/in 7-10 days of exposure; IgG - w/in 15 days

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3
Q

puritic erythema/edema of distal extremities → petechial/purpuric in glove and socks distribution (sharp demarcation)

mucosal involvement (may have oral ulcerations/lesions or pharyngeal erythema)

+/- F/LAD

A

Papular-Purpuric “Glove and Socks” syndrome d/t parvo B19

self-limiting

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4
Q

Non-rash manifestations of Parvo B19

A
  • aplastic crisis in pts w/ SCD/thalassemia (d/t transient disruption to erythropoiesis)
  • chronic infection in IC pts → severe chronic anemia and chronic bone marrow suppression
    • may remain infectious mos-yrs
  • intrauterine infection (IUD, hydrops fetalis) - worse in earlier pregnancy
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5
Q

Enterovirus Classes and spectrum of clinical disease

A

Classes A-D. Polio, “new” enteroviruses (serotype E), coxsackievirus, echoviruses

  • aseptic meningitis +/- rash
  • hemorrhagic conjunctivitis
  • Bornholm disease: epidemic pleurodynia (Coxsackievirus)
  • HFM (CV, enterovirus 71)
  • herpangina (CV)
  • myopericarditis (CV, echo, parecho)
  • paralysis (polio, also with some CV, echo, and entero 71)
  • rash
  • respiratory
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6
Q

summer/early autumn

worldwide

painful ulcerative lesions in oral cavity + vesicles on soles of feet and palms of hands (after oral lesions appear)

may occur on buttocks/genitals

resolve w/in 5-10 days

A

HFM

  • Coxsackie A
  • also CV B and EV71
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7
Q

Clinical syndromes a/w EV71 (largely in Asia-Pacific regions)

A
  • HFM outbreaks
  • aseptic meningitis
  • meningoencephalitis
  • acute flaccid paralysis
  • effects on cardiopulmonary system

vaccine in development

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8
Q

2-4 day prodrome: malaise, high fever, cough, conjunctivitis

rash that begins behind ears, spreads over face → trunk → limbs (erythematous, maculopapular → confluent)

A

Measles

Koplik spots = pathognomonic (white papules on erythematous base during prodromal phase)

infectious from prodrome till 4 days after onset of rash

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9
Q

Complications of Measles

A
  • can have secondary bacterial infections: PNA, OM, croup
  • ADEM = acute disseminated encephalomyelitis (after natural infection>vaccine)
  • MIBE = measles inclusion body encephalitis - progressive/fatal in children w/ impaired cellular immunity
  • SSPE = subacute sclerosing panencephalitis - rare, fatal degenerative neuro condition
    • 5-10yrs after infection (typically in those who were infection <2yo)
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10
Q

prodrome: mild, generalized malaise, +/- mild conjunctivitis, posterior auricular LAD

rash that begins on forehead, then face → rapidly to trunk/limbs (pinpoint lesions)

occurs at same time as prodrome (or 1-5 days after)

A

rubella

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11
Q

Complications of Rubella

A
  • thrombocytopenia - self-limiting, but can result in epistaxis/GIB/hematuria
  • hand/wrist arthritis, lasting for wks
  • encephalitis - usually good prognosis
  • progressive rubella panencephalitis (PRP) - rare, progressive, fatal
    • 2-5yrs post infection
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12
Q
A

Ramsey-Hunt syndrome (HSV) - vesicles in ear or mouth

  • perhipheral facial (VII) palsy
  • may also have auditory (VIII) n sx: tinnitus, vertigo, nystagmus, nausea
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13
Q

EBV rashes

A
  • infectious mono syndrome 80% d/t EBV (20% CMV)- maculopapular (may be urticarial, petechial)
  • Eythema multiforme
  • Cianottie-Crosti syndrome
  • amp/amox a/w rash (usually 5 days into tx)
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14
Q

Clinical features of mumps

A
  • parotitis - 95% of sx cases
  • orchitis, epididymoorchitis, oophoritis - 30% of sx cases
  • CNS: meningitis (1-10%), encephalitis (0.1%)
  • sensorineural hearing loss - common complication, self-limited
  • Other: pancreatitis, myocarditis, thyroiditis, interstitial nephritis, mastitis, hepatitis, migratory polyarthritis
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