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Sohil Rangwala What could it be? Varicella  VZV virus  Usually less than 10 years of age  Significant decrease in incidence since vaccine  Spread by droplets or open sores  Fever, malaise, diarrhea, URI sx  10-21 incubation  Symptomatic treatment Rare..but it happens! Measles  Highly contagious  fever, conjunctivitis , cough, coryza and characteristic     Koplik spots (small white spots in the mouth) Between day 3 and 7 red blotchy rash. non-itchy rash begins on face and behind the ears. Within 24-36 hours it spreads to the entire trunk and extremities No treatment- but immunize! Complications: OM, Pneumonia, glomerulonephritis, SSPE Rubella(German Measles)  Very rare  Spread through direct contact with nasal or throat       secretions Only significant if pregnant Slight fever, sore throat, runny nose and malaise Then begins on the face that spreads to the neck, trunk and extremities Appear as pink or light red spots about 2-3mm in size No treatment- worry is congenital rubella! Congenital Rubella is major concern Roesola  Caused by HHV 6 and HHV 7  characterised by high fever lasting for 3-5 days, runny nose, irritability and tiredness. As the fever subsides, rash appears on the face and body.  Most common 6mos to 3 years • Typically small pink or red raised spots (2-5 mm in diameter) that blanch when touched • Starts on trunk and may spread to involve the neck, face, arms and legs • No specific treatment Parvovirus B19 (Fifth’s disease)  first sign of fifth disease is firm red cheeks, which feel burning hot. A rash follows 1 to 4 days later with a lace or network pattern on the limbs and then the trunk  Can have slight fever, uri and headache as prodrome  Once rash develops, no longer infectious  Concern if exposure during pregnancy  No specific treatment Scarlet Fever  mostly in children aged 4-8 years  GAS is main culprit  sudden fever, sore throat, swollen neck glands, headache, nausea, vomiting, loss of appetite, swollen and red strawberry tongue, abdominal pain, body aches, and malaise  rash appears 12-48 hours after the start of the fever and starts below the ears, neck, chest, armpits and groin before spreading to the rest of the body over 24 hours  Sandpaper appearance  Treatment: treat GAS! Meningitis=BAD  caused by Neisseria meningitidis  fever, headahces, stiff neck, nausea, vomiting,     decreased feeds Petechiae (rash of small red or purple spots that do not disappear when pressure is applied to the skin) occur in 50-75% of cases Rash may progress to larger red patches or purple lesions (similar to bruises) In severe cases lesions may burst and lead to necrosis Early recognition is key! References  http://www.dermnetnz.org/viral/viral-exanthem.html  www. Utdol.com