Often blistering and crusting.
Infectivity when symptoms start
Starts from the top and moves down. Often associated with conjunctival problems.
Incubation 7 - 21days
Infective - before symptoms to four days after appearance of rash
Rash - maculopapular, spreads head downwards
One of cough, conjunctivities or coryza
- Get Koplik's spots, red throat
- throat swab
- notify if suspicious
- off school until 5 days after rash
- need immunoflobulin if under 12months, immunocompromised or pregnant.
- MMR if unimmunised within 72hours of exposure
MMR side effects are in the 2nd week after immunisation - fever and rash.
Rubella or German Measles
It's benign and self eliminating.
- 2 week incubation
- headache, fever, lymphadenopathy
- infective 7 days efore, 7 days after onset of rash
- rash face down to feet
- fever, tender occipital and post auricular lymphadenopthy, arthralgia
- Forschheimer spots - pin-point red macules and petechiae, seen on soft palate and uvula
- Immuniglobulin G and M assays
Slapped Cheek / Parvovirus / Fifth Disease
Pastias lines in the flexural folds with circumoral pallor, and pharyngitis. Desquamation of hands, feet and groin. Rash has a sandpaper-link quality.
- 2-5 days incubation
- infective 5 days from antibiotics
- sore throat, headache, fever, lymphadenopathy, malaise, abdopain. Sandpaper-like rash
Strawberry tongue, pastias lines, circumoral pallor, pharyngitis, desquamation of hands feet and groin.
- notify clinical suspicion
- off school 5 days after antibiotics (HPA)
- for grop A strep tonsillitis 24hours off after antibiotics.
The roseola rash often appears after the fever has settled.
Herpes virus#FOAMed #FOAMpeds #EmergencyMedicine I just saw my 5th case of roseola this month, from the same daycare! As I was looking for a picture to show the parents, I came across this awesome pictorial to differentiate these 3 rashes: Rubella, Rubeola & Roseola. Save it in your phone! pic.twitter.com/Jba4n9EtXq— Adan R Atriham (@GoodCPR) July 12, 2018
Fever + febrile illness
Respiratory illnesss, 3-5days fever, cervical lymphadenopathy
Rash from behind ears - blanching macules and papules surrounded by halos
Nagayama's spots- erythematous papules on the soft palate