Sinoe medical
association
EXANTHEMS :
***MEASLES
***RUBELLA
***ROSEOLA
INFANTUM
***ERYTHEMA
INFECTIOSUM
***VARICELLA
AND HERPES ZOSTER
***SCARLET
FEVER
***ROCKY
MOUNTAIN SPOTTED FEVER
MEASLES:
DESCRIPTION : RUBEOLA
SYMPTOMS: +++COUGH
+++CORYZA
+++FEVER
+++CONJUNCTIVITIS
+++KOPLICK'S
SPOTS
DIAG: +++HISTORY
-PHYSICAL EXAM
+++PHOTOPHOBIA
+++MALAISE
+++MACULES
AND PAPULES
+++SEROLOGY
+++RASH
SPREADS OVER SEVERAL DAYS
PATHOLOGY: +++MEASLES
VIRUS
+++RESPIRATORY
TRANSMISSION
+++INCUBATION
10-15 DAYS
TRT : NONE
+++PREVENT
IMMUNIZATION
+++COMPLICATION
: ***PNEUMONIA
***ENCEPHALITIS
DEF: RUBEOLA: MEASLES:
IS AN ACUTE ,
HIGHLY
CONTAGIOUS VIRAL DISEASE
OCCURS
CHIEFLY IN YOUNG CHILDREN LIVING IN HIGHLY POPULATED AREA
EPIDEMIOLOGY: UNCOMMUN IN DVLPING COUNTRY WHERE VACCINATION IS USED
SPORADIC PROBLEM IN THE US
ETIOLOGY: PARAMYXOVIRUS [MEASLES VIRUS] [ONE SEROTYPE
IDENTIFY]
CLINIC: THREE [3] STAGES : 1/ INCUBATION PERIOD
2/
PRODROME
3/
ERYTHEMATOUS MACULOPAPULAR RASH
1/
INCUBATION PERIOD:
8-12
DAYS
ABSCENCE
SIGNS AND SYMPTOMS
2/
PRODROME
*MALAISE
*FEVER
[UP TO 40.60C -1050F]
*COUGH
*CORYZA
*CONJUNCTIVITIS
*WITHIN
2-3 DAYS AFTER THE ONSET OF SYMPTOMS, KOPLICK'S SPOTS [SMALL, IRREGULAR,
RED SPOTS WITH CENTRAL GRAY OR BLUISH
WHITE SPECKS] ON THE BUCCAL MUCCOSA.
3/
ERYTHEMATOUS MACULOPAPULAR RASH
ERUPTS
ABOUT 5 DAYS AFTER THE ONSET OF SYMPTOMS
THE
RASH BEGINS ON THE HEAD AND SPREADS DOWNWARD
LASTING
ABOUT 4-5 DAYS AND THEN RESOLVING FROM THE HEAD DOWNARD
DIAG: CLINIC
A FOURFOLD
OR GREATER RISE IN HEMAGGLUTINATION INHIBITION ANTIBODIES OVER 2-3 WEEKS
CONFIRMS THE DIAG.
TRT SUPPORTIVE
PREVENTION: LIVE ATTENUATED
VACCINE GIVEN ALONE OR AS A PART OF THE MEASLES, MUMPS, AND RUBELLA OR MEASLES
VACCINES IS HIGHLY PREVENTING MEASLES
IT MAY
PROVIDE PROTECTION IF GIVEN WITHIN THE 72 HOURS OF MEASLES EXPOSURE
IMMUNOGLOBULIN CAN BE GIVEN TO MODIFY OR PREVENT MEASLES IN
A SUCEPTIBLE PERSON IF GIVEN WITHEN THE 6 DAYS OF EXPOSURE.
COMPLICATIONS: RARE
PNEUMONIA
ENCEPHALITIS
SUBACUTE
SCLEROSING PANENCEPHALITIS
PERICARDITIS
HEPATITIS
RUBELLA: GERMAN
MEASLES-3 DAYS MEASLES
DEF: ***VIRAL DISEASE
***INNOCUOUS WHEN
AQUIRED POSTNATALY
***THREE BIG
CONSEQUENCES BEFORE THE VACCINATION :+++CONGENITAL INFECTION==> FETAL DEATH
+++PRENATAL DELIVRY
+++CONGENITAL DEFECT
ETIOLOGY: RUBELLA VIRUS [RNA
VIRUS] = CLASSIFIED AS TOGAVIRUS
CLINIC: ***POSTNATAL
RUBELLA
***CONGENITAL
RUBELLA
DIAG: VIRUS ISOLATION OR SEROLOGIC TECHNIQUES
CONFIRMED BY : TITER OF
HEMAGGLUTINATION INHIBITION OR COMPLEMENT FIXING ANTIBODIES
CONGENITAL RUBELLA ALSO
CAN BE DIAG IN NEONATAL PERIOD BY A POSITIVE IGM ANTIBODY TO RUBELLA VIRUS IN
THE NEWBORN'S SERUM,
INCREASED IGM TITERS
INDICATE RECENT RUBELLA INFECTION OF THE FETUS, BECAUSE IGM DOEN'T CROSS THE
PLACENTA
DIAG DIFFERENTIAL: ENTEROVIRAL
INFECTIONS
ROSEAOLA
TOXOPLASMOSIS
INFECTIOUS
MONONUCLEOSIS
MILD
MEASLES
SCARLET
FEVER
RUBEOLE CONGENITAL : ANOMALIES CARDIOVASCULAR:
***PCA
***CIV
***RM
***TETRALOGY
DE FALLOT
***ANOMALIES
MYOCARDIQUE ET PERICARDIQUE
***CATARACTE
***SURDITE
***IRITIS,
UPHTALMIE
ISOLEMENT DU VIRUS SE
FAIT : :NASOPHARYNX
URINES
SELLES
LCR
PLACENTA
TX
AUGM D'AC ANTIRUBEOLEUX CHEZ LA MERE ET ENFANT [IGM]
EVOLUTION: INFECTION VIRALE EVOLUE PLUSIEURS MOIS ASSOCIE
ALORS UNE FOETOPATHIE AVEC:
+++ICTERE
+++HPSPM
+++PURPURA
THROMBOPENIE
+++ANEMIE
+++MYOCARDITE ++++PNEUNOPATHIE
+++ERYTHROBLASTOSE
+++LESIONS
OSSEUSES ==> BANDE ALTERNATIVE CLAIRE ET SOMBRE AU NIVEAU DU CORPS DE L'OS
THERAPY AND PREVENTION:
***POSTNATAL RUBELLA
USUALLY IS MILD AND SELF LIMITED
NO TRT
TRT OF
CONGENITAL RUBELLA IS SUPPORTIVE
***LIFE ATTENUED VACCINE
GIVEN AT 15 MONTHS AS PART OF THE MEASLES,MUMPS,RUBELLA VACCINE
ROSEOLA
INFANTUM =EXANTHEM SUBITUM=ROSEOLA
COMMON
ACUTE DISEASE OF INFANTS AND YOUNG CHILDREN [IN FIRST FEW YEARS]
CAUSED BY HERPES VIRUS 6
INCUBATION : 5 DAYS TO 2 WEEKS
CLINIC: ***BEGINS
WITH : +++ABRUPT FEVER
+++TEMPERATURE
103-106 [39.5 - 41.2]
+++THE
FEVER PERSISTS 1-5 DAYS
+++ALTHOUGH
THE CHILD APPEAR WELL AND HAS NO PHYSICAL FINDING TO EXPLAIN THE FEVER
***THE
TEMPERATURE USUALLY RETURN TO NORMAL BY THE THIRD OR FIVE DAY OF ILLNESS
+++A
MACULAR OR MACUPAPULAR RASH APPEARS ON THE TRUNK AND SPREADS PERIPHERALLY
[LIGHT PINK IN COLOR]
+++THE
RASH OFTEN RESOLVES WITHIN 24 H
BIOLOGY ***INITIALLY
THE LEUKOCYTES COUNT MAY BE HIGHER AS 20,000 / MM3,
BY THE SECOND DAY OF ILLNESS, LEUKOPENIA
AND NEUTROPENIA ARE NOTED
TRT: ***MOST
CASE ARE BENIGN AND SELF LIMITED
***NO
TRT AVAILABLE
***NO
PREVENTION
COMPLICATION: ***UNCOMMON
***ALTHOUGH
FEBRILE CONVULSION MAY OCCUR
***GOOD
PRONOSTIC
ERYTHEMA INFECTIOSUM
=FIFTH DISEASE
MILD, SELF LIMITED SYSTEMIC ILLNESS ACCOMPANIED BY A DISTINCTIVE RASH.
IT OCCURS PRIMARILY IN EPIDEMICS INVOLVING CHILDREN, ADULT
INFREQUENTLY ARE AFFECTED
CAUSE : HUMAN PARVOVIRUS
CLINIC: ***NO
PRODROME
***FEVER MAY
BE ABSCENT OR LOW GRADE
***SYSTEMIC
SYMPTOMS OCCUR MORE FREQUENTLY IN ADULTS
***RASH
PROGRESSIVE THROUGH THREE STAGES:[RETICULATE PATTERN RASH]
+++RASH
BEGIN AS: MARKED ERYTHEMA OF THE CHEEKS==>SLAPPED CHEEK APPAREANCE
+++ERYTHEMATOUS
MACULOPAPULAR RUSH THEN INVADE THE ARMS,
SPREADS TO THE TRUNK - LEGS
PRDUCING A RETICULAR PATTERN
ITCHING
+++THIRD
STAGE LASTS 2-3 WEEKS BUT MAY PERSIST FOR SEVERAL MONTHS WITH:
-LOW
GRADE FEVER
THIS
STAGE IS CHARACTERIZED BY FLUCTUATIONS IN THE SEVERITY OF THE RASH WITH
ENVIRONMENTAL CHANGES.
TRT: ***SUPPORTIVE
MESURES: ANTIPRURITIC
COMPLICATIONS: RARE ***ARTHRITIS
***HEMOLYTIC
ANEMIA
***ENCEPHALOPATHY
***PARVOVIRUS
B-19 DURING PREGNANCY CAN CAUSE: +++FETAL
HYDROPS
+++DEATH
THE
RISK OF DEATH < 10% FOLLOWING PROVEN MATERNAL INFECTION
VARICELLA
AND HERPES ZOSTER
DIAG: CLINIC
-EARLY IN THE COURSE OF
THE ILLNESS, A TZANCK TEST
SHOULD BE PERFORMED ON SCRAPPING TAKEN FROM THE BASE OF THE VESICLE.
THE DEMONSTRATION OF MULTINUCLEATED GIANT CELLS WITH INTRANUCLEAR
INCLUSIONS INDICATES :
***VARICELLA
***HERPES
ZOSTER
***HERPES
SIMPLEX INFECTION
- DEFINITIVE DIAG
==>POSITIVE CULTURE FROM *A PHARYNGEAL SWAB
*VESICULAR SCRAPING
BY DEMONSTRATION OF A FOURHOLD RISE IN
ANTIBODY TITER BETWEEN ACUTE AND CONVALESCENT SERA
TRT: ***UNCOMPLICATED: ANTIPRURITIC MEDICATION
DAILY
BATHING TO REDUCE SECONDARY BACTERIAL INFECTION
***IMMUNOCOMPROMISED
CHILDREN [ AIDS
LEUKEMIA
ON IMMUNOSUPPRESSIVE DRUGS]
EXPOSED
SHOULD RECEIVE PROPHYLAXIS WITH HERPES
ZOSTER IMMUNE
GLOBULIN + OBSERVATION
IMMUNOCOMPROMISED PATIENTS WITH DISSEMINATED VARICELLA OR HERPES ZOSTER
SHOUL BE TRT WITH :
***VIDARABINE
***ACYCLOVIR
PREVENTION: ***VARICELLA VACCINE = EFFECTIVE FOR HEALTHY
CHILDREN AND FOR CHILDREN WITH MALIGNANCIES
COMPLICATIONS: +++HERPES ZOSTER: ***ENCEPHALOPATHY
***CEREBELLITIS
***GUILLAIN
BARRE SYNDROME
***ASEPTIC
MENINGITIS
***PNEUMONIA
***THROMBOCYTOPENIC
PURPURA
***PURPURA
FULMINANS
***CELLULITIS
***ABSCESS
FORMATION
***ARTHRITIS
+++PROGRESSIVE
VARICELLA OCCURS IN IMMUNOCOMPROMISED CHILDREN AND IS ASSOCIATED WITH A
MORTALITY RATE OF 20%
***MENINGOENCEPHALITIS
***PNEUMONIA
***HEPATITIS
+++MATERNAL
VARICELLA DURING THE FIRST TRIMESTER MAY BE ASSOCIATED WITH ***CONGENITAL
MALFORMATION
SCARLET FEVER
ACUTE ILLNESS
THE DISEASE IS USUALLY ASSOCIATED WITH PHARYNGEAL INFECTIONS
IN RARE CASE FOLLOWS STREPTOCOCCAL INFECTIONS AT OTHER SITES [WOUND
INFECTIONS
IMPETIGO
CHARACTERIZED: ***FEVER
***PHARYNGITIS
***ERYTHEMATOUS
RASH
RARE IN INFANCY
CAN OCCUR MORE THAN ONCE IN A SINGLE PATIENT.
ETIOLOGY: ***GROUP A STREPTOCOCCAL STRAINS PRODUCING ERYTHROGENIC TOXINS
***INFECTIONS
OF OTHER SITES : WOUND INFECTED
IMPETIGO
CLINIC: ***CHARACTERISTIC
RASH IS ERYTHEMATOUS
FINELY PUNCTATE
BLANCHES ON PRESSURE
***APPEARS
INITIALLY ON THE TRUNK
BECOME
GN WITHIN A FEW HOURS TO SEVERAL DAYS
***THE FACE
IS FLUSHED WITH CIRCUMORAL PALLOR, AND THERE IS INCREASED ERYTHEMA IN THE SKIN
FOLDS [PASTIA'S LINES]
***THE SKIN
MAY FEEL ROUGH, SIMILAR TO A SANDPAPER
SKIN FADES
OVER 1 WEEK FOLLOWED BY DESQUAMATION, WHICH MAY LAST FOR SEVERAL WEEKS
***STRAWBERRY
TONGUE: +++ROUGH
+++ERYTHEMATOUS
+++SWOLLEN
TONGUE
***PHARYNGEAL
ERYTHEMA WITH EXUDATE MAY BE PRESENT
DIAG: ***CLINIC
***ISOLATION
OF GROUP A STREPTOCOCCI ON THROAT CULTURE
TRT: ***SAME AS
STREPTOCOCCAL PHARYNGITIS = 10 DAYS ORALLY PENICILLIN
COMPLICATIONS: ***SUPPURATIVE
==> CELLULITIS
***NON
SUPPURATIVE===> RHEUMATIC FEVER
ROCKY MOUTAIN SPOTTED
FEVER
ACUTE FEBRILE ILLNESS
SUDDEN ONSET OF : ***FEVER
***HEADACHE
***MYALGIA
***MENTAL
CONFUSION
***RASH
THE DISEASE MAY BE SEVERE, LEADING TO SHOCK AND DEATH 5-7% OF PATIENTS
EVEN WITH APPROPRIATE ANTIMICROBIAL THERAPY
ETIOLOGY AND EPIDEMIOLOGY:: ***TICK-BORNE ILLNESS
CAUSED BY RICKETTSIA RICKETTSII
***WIDESPREAD
IN US BUT MOST PREDOMINANT IN THE EASTERN COASTAL AND SOUTHEASTERN STATES
***VECTOR:
DERMACENTOR ANDERSONI=WOOD TICK FOUND IN WEST[MOST ACTIVE DURING THE SPRING]
DERMACENTOR
VARIABILIS = DOG TICK , FOUND IN THE EAST [ACTIVE DURING THE SUMMER]
***2/3
OF THE CASES OF ROCKY MOUNTAIN SPOTTED FEVER OCCUR IN PATIENTS WHO ARE UNDER 15
YEARS OLD.
CLINIC: ***INCUBATION
PERIOD :7 DAYS [USUALLY 2-8 DAYS AFTER AN INFECTED TICK BITE
***TYPICAL
INITIAL PRESENTATIONS INCLUDE:
+++FEVER,
WHICH LASTS 2-3 WEEKS IN UNTREATED PATIENTS
+++CHILLS
+++HEADACHE,
WHICH IS GENERALIZED AND SEVERE
+++SIGNS
OF MENINGOENCEPHALITIS : /*/
IRRITABILITY
/*/
CONFUSION
/*/
DELIRIUM
+++MYALGIA
, ESPECIALLY OF THE GASTROCNEMIUS
+++CONJUNCTIVITIS
WITH PHOTOPHOBIA
+++NONPITTING
EDEMA, WHICH MAY BE PROFUSE
***CHARACTERISTIC
RASH DVLPS ON THE THIRD TO FIFTH DAY OF ILLNESS.
THE LESIONS BEGIN AS ROSECOLORED,
BLANCHING MACULES ON THE HANDS
WRISTS , FEET, ANKLES, WHICH SPREAD TO
INVOLVE TO ENTIRE BODY.
THE RASH THEN BECOMES MORE : PAPULAR
PETECHIAL
EVENTUALLY
PURPURIC IF TRT IS DELAYED
DIAG: ***PRIMARILY ON THE BASIS OF
CLINICAL APPEARENCE AND HISTORY
***HISTORY OF TICK BITE
IN 60-85% OF CASES
***ISOLATION OF THE
ORGANISM IS DIFFICULT AND DANGEROUS
***SEROLOGIC
CONFIRMATION GENERALLY TAKES 7-10 DAYS AND MAY BE DELAYED FOR 5 OR MORE WEEKS
IF ANTIBIOTICS ARE BEGUN EARLY
***RAPID DIAG MADE USING
IMMUNOFLUORESCENCE OF A SKIN BIOPSY SPECIMEN.
TRT: ***CHLORAMPHENICOL
OR TETRACYCLINE GIVEN UNTIL 2-3 DAYS AFTER THE TEMPERATURE RETURN TO NL [USUALLY A COURSE OF 5-7 DAYS]
TETRACYCLINE
IS GIVEN ONLY TO CHILDREN OLDER THAN 8 YEARS
***SUPPORTIVE
THERAPY IS ESSENTIAL FOR PATIENTS WITH SERIOUS ILLNESS [SHOCK]
PREVENTION: ***AVOIDING THICK
INFESTED AREAS AND BY A PROMPT REMOVAL OF A THICK [WITH FORCEPS APPLIED TO THE
HEAD
COMPLICATION: ***FOCAL NEUROLOGIC DEFICITS
***COMA
***RENAL
FAILURE
***DISSEMINATED
INTRAVASCULAR COAGULATION
***GANGRENE
OF THE DISTAL EXTREMITIES AND SCROTUM
***PNEUMONIA
***SHOCK
LEADING TO DEATH
MALADIES DES INCLUSIONS CYTOMEGALIQUE:
CONSEQUENCE: FOETOPATHY
GERME: VIRUS DES INCLUSIONS CYTOMEGALIQUES
CLINIQUE: LA FORME CLINIQUE LA PLUS TYPIQUE ASSOCIE:
***ICTERE
PRECOCE [BILI DIRECT]
***HPM
***PURPURA
THROMBOPENIQUE CYTOPENIQUE
***S
NEURO MENINGO ENCEPHALITE VIRALE
FORMES CLINIQUE: ***F
DISSOCIEE
***F.
ATTENUEE
***F.CHRONIQUE: +++ATTEINTE OCULOCEREBRALE
MICROCEPHALIE- CHORIORETINITE
+++CALCIFICATION
INTRA CRANIENNE
+++IMPORTANT
RETARD PSYCHOMOTEUR
DIAG +: ***RECHERCHE DE
CELLULES PATHOGNOMONIQUE: +++GRANDE
CELLULES
+++INCLUSION
INTRA CYTOPLASMIQUE
+++INCLUSIONS
INTRA NUCLEOLAIRE
DANS
LE LCR
URINES FRAICHES
TEST
D'INIBITION DE L'HEMAGLUTINATION
TAUX D'IG M
SPECIFIQUE AUGM
MUMPS:
Highly contagious , acute generalized viral disease.
Painful enlargement of the salivary glands [primarily the parotids]
THE DISEASE IS BENIGN AND RESOLVES SPONTANEOUSLY
20-40% OF INFECTIONS ARE SUBCLINICAL.
EPIDEMIOLOGY: EPIDEMICS ARE MORE FREQUENT DURING THE WINTER AND SPRING.
THE
DISEASE IS UNCOMMON IN INFANTS YOUNGER THAN 1 YEAR
THE
HIGHEST INCIDENCE IS IN SCHOOL AGE CHILDREN
ETIOLOGY AND PATHOGENESIS:
-CAUSED
BY : PARAMYXOVIRUS
-ISOLATED
FROM THE SALIVA, CFS, BLOOD , URINE AND INFECTED TISSUES OF MUMPS TISSUE.
-SPREAD: ***DIRECT CONTACT
***AIRBORNE
DROPLET NUCLEI
***FOMITES
THAT HAVE BEEN CONTAMINATED BY SALIVA
-VIRUS
TRANSMISSION GENERALLY OCCURS DURING THE PERIOD 48 H BEFORE THE APPEARENCE OF
SALIVARY GLAND SWELLING TO 7 DAYS AFTER ITS APPEARENCE.
CLINIC: -INCUBATION
PERIOD: 2 TO 4 WEEKS [16-18 DAYS]
-PRODROME:
***FEVER
***ANOREXIA
***HEADACHE
***MALAISE
[UNCOMMON]
-
WITHIN ONE DAY, THE ILLNESS MANIFESTS: ***PAIN
AND SWELLING IN ONE OR BOTH PAROTID GLANDS
***PAIN AND ERYTHEMA OFTEN OCCUR AT
THE OPENING OF THE PAROTID DUCT: STENSEN'S DUCT
+++THE
SWELLING USUALLY PEAKS 1-3 DAYS AND THEN RESOLVES OVER 3-7 DAY PERIOD.
+++SUBMANDIBULAR
OR SUBLINGUAL GLAND SWELLING MAY ACCOMPANY THE PAROTITIS BUT RARELY IS THE ONLY
MANIFESTATION OF DISEASE.
-
FEVER USUALLY MODERATE
TEMPERATURE
MAY REACH 1040 F [400 C]
FEVER
ABSCENT IN 20% OF CASES
BIOLOGY: -ELEVATED SERUM AMYLASE
DIAG - CULTURE OF THE VIRUS FROM THE
SALIVA, URINE, CSF, BLOOD
-DEMONSTRATION OF
SIGNIFICANT RISE IN CIRCULATING MUMPS ANTIBODY FROM THE ACUTE TO CONVALESCENCE STAGE.
DIAG DIFFERENTIAL : ***ACUTE PAROTITIS [COXSACKIE A VIRUS INFECTION , OR
LYMPHOCYTIC CHORIOMENINGITIS
***SUPPURATIVE
PAROTITIS
***RECURRENT
PAROTITIS [ALLERGIC ORIGIN]
***SALIVARY
CALCULUS
COMPLICATIONS: ***MENINGOENCEPHALITIS: MOST FREQUENT COMPLICATION IN CHILHOOD
10%
OF THE PATIENTS
MOST
COMMON CAUSE OF ASEPTIC MENINGITIS
***EPIDIDIMO-ORCHITIS
***PANCREATITIS
***UNILATERAL
DEAFNESS: HEARING LOSS IS COMPLETE AND PERMANENT
***OOPHORITIS
***NEPHRITIS
***THYROIDITIS
***MYOCARDITIS
***ARTHRITIS
***THROMBOCYTOPENIC
PURPURA
***MASTITIS
TRT: SYMPTOMATIC AND SUPPORTIVE
PREVENTION: ***PASSIVE PROPHYLAXIS
NOT EFFECTIVE
***ACTIVE
IMMUNIZATION WITH LIVE ATTENUATED MUMPS VACCINE IS EFFECTIVE FOR PREVENTION OF MUMPS AND HAS FEW SIDE EFFECTS
INFECTIOUS
MONONUCLEOSIS
ACUTE INFECTION
FEVER- SORE THROAT- LYMPHADENOPATHY- SPLENOMEGALY- ATYPICAL
LYMPHOCYTOSIS- PRESENCE OF
HETEROPHIL ANTIBODY
AFFECT MOST OFTEN ADOLESCENTS AND YOUNG ADULT
ETIOLOGY: CAUSE : EPSTEN BARR VIRUS
HERPES
VIRUS
CYTOMEGALOVIRUS
T.
GONDII
CLINIC: LESS
SEVERE IN YOUNG CHILDREN THAN IN THE OLDER CHILDREN, ADOLESCENT OR ADULT
PRODROME
: MALAISE -FEVER- HEADACHE
MAY
EXTEND FOR 3-7 DAYS BEFORE THE ONSET OF MORE PROFOUND SYMPTOMS
***FEVER:
LAST AS LONG AS 21 DAYS
EXCEEDS
104 F [40 C]
***PHARYNGITIS:
80%
GROUP
A STREPTOCOCCUS MAY BE CULTURED FROM THESE PATIENTS
***LYMPHADENOPATHY:
POSTERIOR CERVICAL NODES
***SPLENOMEGALY
***RASH:
10-40% OF PATIENT
MACULOPAPULAR AND GN
IT DVLPS IN ALMOST ALL PATIENTS WHO ARE
GIVEN AMPICILLIN
***
FATIGUE - EYELID EDEMA - ABDOMINAL PAIN - RARELY JAUNDICE
DIAG: ***POSITIVE
SEROLOGIC FINDING
+++PAUL BUNNELL DAVIDSOHN TEST==>
HETEROPHIL ANTIBODIES
+++MONOSPOT TEST [YOUNGER THAN 5
YEARS OLD WITH EPTEIN BARR VIRUS INFECTION HAVE FALSE NEGATIVE RESULTS.
+++ANTI BODIES TO EPSTEIN BARR VIRUS
/*/
EPSTEIN BARR VIRAL CAPSID ANTIGEN = VCA
/*/
EPSTEIN BARR NUCLEAR ANTIGEN = EBNA
/*/
EPSTEIN BARR VIRUS INDUCED EARLY ANTIGEN
VCA= IGM FOLLOWED BY IGG PEAK IN THE SECOND OR THIRD WEEK OF ILLNESS AND
PERSIST FOR LIFE
EA= APPEAR
EARLY IN THE COURSE OF THE ILLNESS AND DISAPPEAR 2-6 MONTHS LATER
EBNA=
APPEAR 3-6 MONTHS AFTER THE ONSET OF INFECTION AND PROBABLY PERSIST FOR LIFE
TRT : ***REST
***NO
SPECIFIC DRUG
***CONVALESCENCE
= WEEKS TO MONTHS , SHORTER IN YOUNGER PATIENT
COMPLICATIONS: ***SPLENIC RUPTURE
***AIRWAY
OBSTRUCTION ==> TONSILAR OR PHARYNGEAL HYPERTROPHY
***NEUROLOGIC
COMPLICATION: /*/ ASEPTIC
MENIGITIS
/*/
ENCEPHALITIS
/*/
MYELITIS
/*/
PERIPHERAL NEUROPATHIES
/*/
GUILLAIN BARRE SYNDROME
***
ICTERE HEPATITIS: 5%
SUBCLINICAL
20-30%
ACUTE
LIVER FAILURE : RARE
***AUTOIMMUNE
HEMOLYTIC ANEMIA
***THROMBOCYTOPENIA
***NEUTROPENIA
***ACUTE
RENALE FAILURE
***COMPLETE
HEART BLOCK
***MYOSITIS
***PERICARDITIS
***PNEUMONIA
***ACROCYANOSIS
***IMMUNOLOGIC
DISORDERS +++IMPAIRED CELL MEDIATED IMMUNITY
+++AGAMMAGLOBULINEMIA
UPPER AIRWAY INFECTIONS
1/ OTITIS MEDIA
2/ SINUSITIS
3/ INFECTIONS OF THE ORAL CAVITY. GINGIVITIS AND STOMATITIS
4/ STREPTOCOCCAL PHARYNGITIS
5/ CERVICAL ADENITIS
6/ CROUP
STREPTOCOCCAL PHARYNGITIS:
ENCEPHALITIS
RUBEOLE= RUBELLA
=EPIDEMIC ROSEOLA = GERMAN MEASLES
ROUGEOLE=
MEASLES=MORBILI = RUBEOLA
VARICELLE= CHICKENPOX
=VARICELLA
VARIOLE= SMALL POX=
VARIOLA
scarlatine: scarlatina,
scarlet fever
OREILLONS: MUMPS,
CONTAGIOUS PAROTIDIS
COQUELUCHE:
WHOOPING-COUGH, PERTUSSIS