Classic Pediatric Viral Exanthems

Kami D MS III SGU Pediatrics – Clerkship Woodhull Medical & Mental Health Center 4/20/12

Fever is absent or low grade Rash: •“Slapped Cheek” • Puritic • Maculopapular rash • Starts on arms and spreads to the trunk and legs • Worsens with fever or sun exposure .Erythema Infectiosum Fifth Disease Causative Virus: Parvovirus – B19 Prodrome: None.

Complications: -Arthropathy in children and adults. Severe Iron Deficiency Anemia) . hereditary spherocytosis) or in those with decreased RBC production (eg. Sickle Cell Anemia. -Congenital infections associated with hydrops and death -Aplastic crisis may be percipitated in children with high RBC turnover (eg.

cough. Which of the following is the most likely diagnosis? A) Parvovirus B) Rubella C) Herpes D) Rubeola E) Varicella . fever to 41. He is noted to have white pinpoint lesions on a bright red buccal mucosa in the area opposite his lower molars. He then develops the erythematous.1 ° (106 °F). coryza and conjuctivitis. maculopapular rash pictured.The child shown in the image presents with a 3 day history of malaise.

Measles Rubeola Causative Virus: Paramyxovirus Prodrome: •Low grade fever •Cough •Coryza •Conjunctivitis 1-2 days later….. Koplicks spots (small irregular red spots with central gray specks on buccal mucosa) .

Measles Rubeola Rash: •Erythematous •Maculopapular •Spreads from head to toe Common Complications: •Otitis media •Pneumonia •Laryngotracheitis Rarely. subacute sclerosing panencephalitis .

the rash has vanished. Four days after the onset of her illness. Which of the following is the most likely diagnosis? A) B) C) D) E) Rubella Rubeola Roseola Erythema Infectiosum Erythema Multiforme .A 14 year old girl awakens with a mild sore throat. her physician notes mild tenderness and marked swelling of her posterior cervical and occipital lymph nodes. During the next 24 hours. she develops tender swelling of her wrists and redness of her eyes. low grade fever. In addition. and diffuse maculopapular rash.

Rubella 3 Day Measles German Measles Causative Virus: Rubella Virus Prodrome: •Asymptomatic or tender lymphadenopathy Posterior Auricular lymphadenopathy Rash: •Erythematous •Tender •Maculopapular •Head to toe .

Rubella 3 Day Measles German Measles Complications: Encephalitis. mental retardation) . thrombocytopenia ( a rare complication of a postnasal infection) Congenital Rubella: Associated with congenital anomalies (PDA. deafness. cataracts.

did not look sick and his neurologic examination was normal.A 11 month old boy has had a fever of 103-104 °F for 4 days and was seen in the ED because of febrile seizures. The only finding at the time was a small suboccipital lymph nodes. but now he has a maculopapular rash. A)Rubella B)Rubeola C)Measles D)Exanthema Subitum . Three days later. He had no vomiting. No workup was done. the child’s fever has resolved.

>104°) with no other symptoms for 3-4 days Rash: •Maculopapular – APPEARS WHEN FEVER BREAKS •Begins on the trunk and quickly spreads to the face and extremities •Generally lasts <24 hours Complication: febrile seizure .Roseola Infantum Exanthema subitum 6th Disease Rose Rash Causative Virus: HHV 6 + 7 Prodrome: Acute onset high fever (>40°C.

Varicella Chicken Pox Causative Virus: Varicella Zoster Prodrome: Mild fever. anorexia and malaise precede the rash by 24 hours Rash: •Puritic •“tear drop” vesicular periphery •Lesions at different stages of healing •Usually appears on the face and then spreads to the rest of the body. SPARING palms and soles •Infectious 24 hours before eruption until lesions crust over .

Guillian-Barre syndrome. starting with pain along an affected sensory nerve Rash: Puritic “teardrop” vesicular rash in a dermatomal distribution. UNCOMMON unless IMMUNOCOMPRIMISED Complications: Encephalopathy. TTP. pneumonitis. cellulitis.Varicella Zoster Shingles Causative Virus: VZV Prodrome: Reactivation of varicella infection. aseptic meningitis. arthritis .

anorexia.Hand-Foot-and-Mouth Disease Causative Virus: Coxsackie A Prodrome: Fever. Rash: •Oral Ulcers •Maculopapular vesicular rash on hangs and feet and sometimes on the buttocks . oral pain.