8. Exanthemata/Cutaneous manifestations of infection

Question 1

Causative organism of measles

Answer 1

Measles morbillivirus

Question 2

Causative organism of scarlet fever

Answer 2

Streptococcus pyogenes

Question 3

Causative organism of rubella

Answer 3

Rubella virus

Question 4

Complications of scarlet fever

Answer 4

causes a wide range of infxns in humans including necrotizing fascitis and immune mediated consequences

Question 5

Describe rash in measles

Answer 5

Widespread blanching erythematous maculopapular rash

Discrete papules

Question 6

What is the clinical course of measles

Answer 6

Incubation period of 7-18 days
Initial prodrome of fevers for 2-4 days with evolving coryza, conjuctivitis and kopliks spots (small, bluish white, firm lesions on buccal mucosa)
Spread from head to tail, starts with small macules or papules and eventually becoming confluent
Blanching initially, can become non blanching and eventually non-blanching and skin can become quite discoloured

Question 7

Mx of Measles

Answer 7

IgM antibodies, management mainly supportive, inform PH

Question 8

How is measles spread

Answer 8

By droplets and contaminated surfaces

Question 9

Compl of measles

Answer 9

Pulm measles- severe ARD like illness of lung inflammation
Encephalitis

Question 10

Must measles be notified to PH

Answer 10

Yes

Question 11

Sx of scarlet fever

Answer 11

pharyngeal infxn with fever, cervical lymphadenopathy and headache

Rash will only appear 1-2 days after sore throat, may appear on whole back for example
May have strawberry tonque,pastia’s lines and rash is folllowed by desquamation

Question 12

Is rash in scarlet fever blanching or non blanching

Answer 12

Blanching

Question 13

Complications of scarlet fever

Answer 13

Post strep glomerulonephritis
RHEUMATIC fever- 3 weeks after pharyngeal strep infxn (Multi system AI disorder occurring 3 wks after pharyngeal strep infxn, may result in pancarditis or athritis, or lead to valvular insufficiency and increase risk of infective endocarditis

Question 14

Sx of rubella. What is characteristic of this

Answer 14

Widespread blanching erythematous macular rash with > 1cm discrete macules and large areas of confluence. may be itchy, no desquamation or skin staining

Post auricular lymphadenopathy and palate petechiae’

Question 15

How is rubella spread

Answer 15

Also droplets and contaminated surfaces, like measles

Question 16

Is there fever and prodrome in rubella

Answer 16

yes, prodromal fever. Rash only appears after 2-3 days.

Question 17

Symptoms of congenital rubella syndrome

Answer 17

Hepatitis and jaundice, rash, thrombocytopenia, anaemia, lymphadenopathy

May result in patent ductus arteiosus, cataracts and sensorineiral deafness ‘

Increased risk of insulin dependent diabetes, thyroid disease and progressive hearing or visual loss

Question 18

What causes slapped cheek ( papular rash on cheeks) and is it itchy or painful. What other manifestations are possible. Is fever possible

Answer 18

Parvovirus, not itchy or painful
Gloves and socks- Maculopapular rash symmetrically affecting feet, painful, significant oedema and non-blanching
Yes fever then rash ( initially on face before becoming generalised)

Question 19

Parvovirus complications

Answer 19

May precipitate arthritis especially in adults, cause aplastic crisis in pts with pre-existing haemolytic anaemia, chronic infection and anemia in immunocomompromised pts
May have foetal anaemia

Question 20

Mpox main group of pts

Answer 20

MSM

Question 21

Disease causing swelling and redness of leg

Answer 21

Cellulitis

Question 22

What does a small patch of vesicles of a single dermatome erupting suggests

Answer 22

VZV, shingles

Question 23

What do systemic features with fevers, weight loss and tiredness together with rash suggest

Answer 23

Endocarditis

Question 24

What kind of rash is present in HIV

Answer 24

Diffuse maculopapular rash

Question 25

Rashes in chicken pox

Answer 25

Starts as erythamatous macule, that becomes papule (raised), blisters to form vesicle, which becomes pustule when serous fluid becomes pus. Skin breaks and leaves ulcer Usually spends most time as vesicle

Question 26

How is chickenpox spread and what are sx

Answer 26

Via resp route Fever, itchy rash starting on head/trunk before spreading.

Question 27

Mx of chicken pox

Answer 27

Calamine lotion, keep cool, school exclusion, immunocompromised and newborns with periparum exposure should receive VZIG, consider IV aciclovie if chickenpox develops

Question 28

What is a non-blanching erythematous rash likely to be

Answer 28

Meningococcal,

Question 29

What leaves a blanching rash with a handprint when pressed

Answer 29

Dengue virus

Question 30

What leaves a blanching maculoopapular rash, commonly found in the tropics

Answer 30

Zika virus, maybe dengue or chikungunya

Question 31

What can result in a morbilliform rash (blanching maculopapular rash, not due to measles)

Answer 31

Reaction to penicillinn

Question 32

What is a salmon pink blanching maculopapular rash on torso likely to be

Answer 32

Still's disease, associated with fever and lymphadenopathy

Question 33

When does mumps tend to occur

Answer 33

Winter and spring

Question 34

Fx of mumps

Answer 34

Fever, malaise, PAROTITIS- earache, pain on eating