Infectious Exanthemas - Anderson Flashcards
What is the difference between an exanthema and an enanthema?
Both are manifestations of an underlying problem
Exanthema - rash expressed on cutaneous surface
Enanthema - expressed on mucosal surface
A small growth begins on surface of skin and gradually enlarges over a long period. Relatively few symptoms are experienced, although when on foot, some pain may be experienced. Frequently, small black dots are seen centrally. Surface exhibits hyperkeritinazation.
What is the infection????????
Warts!
Human papilloma virus
How is HPV transmitted, and how do you manage this disease?
transmitted by person-person contact or fomites
Use liquid N2, acids, laser, surgical
prevent with sandals, immunizations
Asymptomatic, discrete papular, waxy lesions gradually develop on surface of skin. Each has an umbilicated appearance. Generally only a few are present (2 - 20), but in a generalized location.
What’s the infection?
molluscum contagiosum - one of the pox viruses
- Management: mechanical removal of central core (which contains the virus), liquid N2, acids
- avoid direct contacts, sharing of towels and washcloths
A vesiculated rash spreading from distal distribution to central begins to develop in a toxic appearing individual. Symptoms consist of headache, fever to 102-5 degrees, extreme malaise, and muscular pains preceding the rash. Rash develops with same stages present in local crops and becomes encrusted during its development. Illness lasts for two weeks and resolves with significant scarring. A hemorrhagic form is highly fatal.
What is the infection?
Variola (small pox)
Whoa…. scary!
Transmission: direct contact with skin lesions and mucous membranes, human transmission although some animal poxviruses can be transmitted winter and spring peak incidence
Management: strict isolation, symptomatic treatment, active immunization, VIG within 24 hours of contact if possible
Let’s say you’re out herding sheep on your weekend-dude ranch-getaway that you just won on The Price is Right. Why would it be a good idea to wear gloves?
You could catch a zoonotic infection called the Orf Virus
You would usually see it as a solitary lesion on the hand, beginning as an erythematous papule, turns into vesicle
Just treat the symptoms!
Symptoms begin with a general malaise, mild fever (101 - 102 degrees) and pruritic rash beginning centrally on head and trunk and then extending peripherally. Rash rapidly develops from macule and papule to a vesicle in 24 hours.
Rash clears over a week to ten days. A latent infection may ensue and Reye syndrome seen in individuals treated with aspirin.
What is the disease?
Chickenpox!
Herpes virus, varicella zoster!
A 13 year old presents with stinging erythematous lesion develops at junction of skin and lip. Proceeds to a crusted sore over a few days but lasts up to 10 to 12 days. No systemic symptoms are noted.
Also lesions of oral cavity - gingiva and tongue and genital region may be found.
What’s your diagnosis doctor?
Herpes simplex, types 1 and 2
Transmission:direct contact, sexual and birthing contacts, associated with stress
Can become latent and recurrent
Management: drying agents, acyclovir ointment locally, acyclovir, famciclovir, valaciclovir, penciclovir - oral and intravenous
protect newborns from exposure, special precautions during pregnancy (c sections)
Six month old infant develops a high fever (102 - 105 degrees) with minimal respiratory symptoms preceding. Infant seems playful in spite of fever. After about 3 days the fever breaks and a fine maculopapular rash develops on neck and trunk, then to disappear in two days.
What on earth is going on with this child?
Roseola virus
Observe in case of febrile convulsions
(dont accidentally call it a penicillin allergy!)
17 year old girl comes into the clinic with sore throat, mild fever, enlarged lymph nodes and extreme tiredness over three to four days. The tiredness lingers a week or more after the other symptoms resolve. A maculopapular rash is noted on the trunk.
What is the diagnosis?
Too much kissing…
JK ! Sort of… Epstein Barr virus, Infectious mono
Passed by close contact
Enlarged lymph nodes and spleen is probs present, do rapid mono test
Treat symptoms, avoid contact sports
A young child develops malaise and mild fever. Complaints of sore throat and lesions in mouth and on extremities. Enanthem occurs within one or two days after onset of symptoms and exanthem occurs shortly thereafter. Lesions clear within a week.
What could it be?
Hand foot and mouth disease! Coxsackie Virus!
Nasopharyngeal, saliva, fecal transmission
Try to protect the newborns from this, use good personal hygiene to avoid
A young child comes in with flu-like symptoms, mild fever, abdominal cramps, diarrhea, maculopapular rash of trunk. After going home the rash and symptoms fade in 5 days. What did the child have?
Echo vrius
fecal-oral transmission
treatment: be careful changing diapers, use meds for symptoms, good personal hygiene is a must
A 5th grader comes into clinic with very erythemous “slapped” cheeks. A “lacy rash” covers his extremities. What is it?
Fifth disease! (a parvovirus)
Protect pregnant women from exposure (can be bad for fetus)
A first grade girl just got back from a vacation in Europe. Her parents do not believe in vaccinations because they think Jenny McCarthy is a world expert on disease. She develops rhinitis and cough as well as conjunctivitis. She also has a red rash spreading from the central to distal body parts. She has a fever of 104 as well as small mucosal oral lesions on the buccal mucosa.
What does the child have?
Measles!
School age child develops mild upper respiratory symptoms and malaise with low grade fever. Shortly thereafter, a fine maculopapular rash develops on upper body and spreads to lower body. It rapidly clears in same fashion over three days. An enanthem, Forchheimer spot appear on the soft palate/uvula.
What does the child have?
Rubella
