Case 3.1
A 7-year-old boy is brought to the ED by his mother after she noticed the rash below on his body. The mom states that the rash first appeared on her son’s face and then rapidly spread to his neck, back, chest, and legs. Mom states that her son complained of a sore throat for the last couple of days and he had a low-grade fever. Mom states that her son is vaccinated with all vaccines except those that have live viruses. On exam, you note postauricular and posterior lymphadenopathy. The rash is pink to red and maculopapular.
1. What is the diagnosis?
2. What vaccine could have prevented this condition?
3. What is the most concerning complication of this condition?
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Filed under: VizD Tagged: | systemic infections
1. Measles/Rubella (German Measles)
2. MMR
3. Encephalitis/SSPE
1.) Measles
2.) MMR
3.) encephalitis (subacute sclerosing panencephalitis)
1. Rubella
2. MMR
3. encephalitis
The child has rubella, aka german measles, and this could have been prevented with the MMR vaccine. The most serious complication of this condition is not a concern for this patient because he is both too young and too male to be pregnant. The complication is congenital rubella syndrome. Also, it helps to confirm the diagnosis when the first picture to show up in google images when rubella is seached is the exact picture in question
1. Rubella
2. MMR
3. mild, self limiting usually if postnatal, usually arthralgias
most feared is infection of mother to
fetus in first trimester leading to congenital rubella syndrome causing spontaneous abortion 20%,
if the baby survives most common cardiac manifestation is PDA, multiple organ system failure
1. Measles
2. MMR
3. Pneumonia is a common complication. May also cause encephalitis.
Rubella / German Measles
MMR
Encephalitis
1. Rubella “German Measles”
2. MMR vaccine would have prevented this
3. Of concern is that this child’s respiratory secretions can transmit the rubella virus and if a pregnant women in her 1st trimester comes in contact with this child she may put her fetus at risk of congenital rubella syndrome; cataracts, CNS defects like MR and deafness, hepatitis and heart disease.
Measles
MMR
Encephalitis and/or corneal involvement
Ansurs!
1. Rubella would be my guess because of the vaccine clue, but the picture looks like scarlet fever too.
2. MMR
3. there are teratogenic effects if a fetus contracts rubella.
Measles
MMR could have prevented
Encephalitis is the most fatal/serious complication but it is rare.
1) Measles
2) MMR
3) Encephalitis