FEVER WITH RASH
Dr. Mohamed Sadek
Ass. Lecturer of pediatrics at Luxor university
SKIN RASHES
• A papule is a circumscribed, solid elevation
of skin with no visible fluid, varying in size
from a pinhead to 1 cm.
• Vesicle: is a circumscribed, fluid-containing,
epidermal elevation generally considered
less 10mm in diameter at the widest point.
• Pustule: is a small elevation of the skin
containing cloudy or purulent material
usually consisting of necrotic inflammatory
cells. These can be either white or red.
• Macule: is a change in surface color, without
elevation or depression and, therefore,
nonpalpable, well or ill-defined, variously
sized, but generally considered less than
10mm in diameter at the widest point.
COMMON INFECTIONS
MEASLES
• It’s a viral disease
• Mode of Transmission:
• Contact with secretions or droplets of an infected
child.
• Period of Infectivity:
• 4 days prior to and 5 days after appearance of the rash.
• Incubation period:
• 10-12 days
CLINICAL MANIFESTATIONS:
• Prodromal stage with an enanthem (Koplik
spots), usually lasts 3-5 days.
• Koplik spots are grayish white dots on an
erythematous base on the anterior portion of the
buccal mucosa. With appearance of rash, Koplik
spots start to disappear.
• Final stage starts with a maculopapular rash
accompanied by high fever.
• The rash starts behind the ears, and along the
hairline. Then the rash spreads on the face, neck,
upper arms, and upper part of the chest within
the first 24 hours.
CLINICAL MANIFESTATIONS:
• On 2nd day. The rash appears on the back,
abdomen, arms and thighs.
• On 3rd day. It reaches the feet and begins to
fade on the face.
• 3 days to appear and 3 days to disappear
• An abrupt drop in temperature to normal.
• The rash fades downward in the same
sequence in which it appeared
MEASLES
KOPLIK’S SPOTS
MEASLES
• Why infants below 6-9 months are protected
?????
• Due to the transplacental acquired
immunoglobulins (IgG) from the mothers
who have had the infection or the vaccine
RUBELLA
• It is a viral infection
• Mode of Transmission:
• Droplet infection or direct contact with a case
• Transplacental from infected mother.
• Incubation Period:
• 2-3 weeks
• Period of Infectivity:
• 7 days before exanthema and 7-8 days after its
disappearance.
• Infants with congenital rubella are contagious for
at least 1 year
CLINICAL MANIFESTATIONS:
• Lymphadenopathy is evident at least 24hr before the
rash appears.( where?)
• Rash begins on the face and spreads quickly on the
first day.
• 2nd day. The rash is confluent and pinpoint like that
of scarlet fever with mild itching.
• 3rd day. The rash generally disappears with minimal
desquamation and no scaring.
• Rubella without rash may occur as fever with
enlarged tender lymphadenopathy which may
persist for a week or more.
RUBELLA
SCARLET FEVER
• it is a bacterial disease
• Mode of Transmission:
• Droplet infection or direct contact with a case
• Incubation Period:
• 2-5 days
• Period of Infectivity:
• During the acute and sub-clinical
phase
CLINICAL MANIFESTATIONS:
• Most common 2 features:
• Pharyngitis/tonsillitis
• Lingual changes ( white and red strawberry tongue)
• Rash:
-coarse sandpaper -blanches with pressure
-pruritic -not painful
-intense along skin folds and produces lines of confluent
petechiae known as the Pastia sign
• Flushed face with Circumoral pallor
• Rash fades 3-4 days after onset with branny
desquamation
SCARLET FEVER
ROSEOLA INFANTUM
• It is a viral disease
• Almost exclusively in infants and young
children
• Mode of Transmission:
• Droplet infection
• Incubation Period: 1 - 2 weeks
CLINICAL MANIFESTATIONS:
• Prodrome of mild rhinorrhea, and mild redness of
conjunctiva and pharynx.
• Sudden high fever lasts 3-4 days without any
localizing signs (?+febrile convulsions)
• Maculopapular rash appears on the 4th day with the
drop of fever. It starts on the trunk and rapidly
spreads over the arms and neck, leaving the face
minimally involved, and lasts only 24 hours.
• This occurrence of rash is described as a "Rainbow
following the storm".
ROSEOLA INFANTUM
CHICKENPOX
• It is a viral infection
• Mode of Infection:
• Direct contact.
• Droplet infection.
• Air borne.
• Period of Infectivity:
• Extends from one day before the onset of rash till
crusted.
• Incubation Period:
• 2-3 weeks.
CLINICAL MANIFESTATIONS:
Prodromal stage: very mild and short.
Eruption stage:
.pleomorphic rashes .centripedal
The rash appears as crops of macules which within hours
pass through a papular stage, then progress to develop
vesicles and pustules.
Pruritus may be intense.
ulceration in the mouth may occur
CHICKENPOX