DiagnosisName the oral findingOrganismComplications
1
• Paramyxovirus
• Droplet spread
• Incubation 8-14/7
• Prodrome-coryza,cough,conjunctivitis
• Koplik’s spots
• Rash,fever
• Rx-symptomatic,antibiotics
Measles
• Respiratory• LTB• Bronchiolitis• pneumonia
• Ophthalmic• Conjunctivitis• keratitis
Complications: measles 1
• Ear• OM• Perforation• mastoiditis
• GI ● gastroenteritis
• CNS• febrile fit• Encephalomyelitis• SSPE
Complications: measles 2
2
Scarlet fever
• Gp A beta haemolytic strep.
• Incubation 2-4/7
• Fever
• Headache
• Sore throat
• High fever
• Tachycardia
• Rash:• Axillae• Groins to trunk• Limbs• Sandpaper appearance
• Circum-oral pallor
• Desquamation
• Strawberry tongue, white and red
Scarlet fever
Complications
• Cervical lymphadenitis, • OM, • sinusitis, pharyngeal abscess• Bacteraemia
• Pneumonia• pericarditis
• Late• Rheumatic fever• acute GN• erythema nodosum
• Rx-penicillin
3
Fifth Disease (Erythema Infectiosum)]
Slapped-cheek appearance
Bright erythema appears over the cheeks
Erythematous eruption occur mainly on extremities
Occurs in the 3- 15 year age group
Polyarthropathy is a feature
Disease usually self limiting
4
Rubella
• Virus
• Incubation 14-21/7
• Rash-face to trunk then limbs
• Fine pink macules, coalesce
• Tender LN• postauricular• suboccipital• cervical
Rubella: complications 1
• Polyarthritis• Adults• Hands• wrists
• CNS• Encephalitis• Myelitis
• Thrombocytopaenia
• Infection up to 16/40 pregnancy• Early:
• abortion
• Later: • IUGR• Microcephaly• Microphthalmia• Cataract• CHD• deafness.
• Rx-symtomatic
Rubella: complications 2
MeningitisPetechial rash
Purpuric
Non blanching
Systemically unwell
Treatment
Antibiotics
Fluids
ITU (transfer)
Intubation
Contact tracing
5
Kawasaki Disease
6
Kawasaki Disease
•Acute febrile vasculitis syndrome of early childhood usually <5y.
• 5 criterion for diagnosis:• Fever for 5+ days• Polymorphous erythematous rash• Nonpurulent bilateral conjunctival injection• Oropharyngeal changes• Peripheral extremity changes
5 criterion for diagnosis:– Changes in lips and mouth– reddened, dry or cracked lips– strawberry tongue– Cervical lymphadenopathy
Kawasaki Disease
Management:
Refer for urgent paediatric assessment.
7
•Common <10y.•Incubation: 10-21 d•Rash +/- fever.
– Spots appear in crops on skin &mucus membranes
– progress from macule> papule>vesicle. – Appear for 5-7d. – Vesicles dry out and scab over (usually in <14d).
Chicken Pox
• Mx: supportive – Paracetamol– fluids – topical calamine lotion
• Complications: – Eczema herpeticum– Encephalitis– Pneumonia
Chicken Pox
Impetigo
Causative agent Staph. aureus.
Lesions• Honey coloured
• crusted
• erythematous
• macules
Commonly on face
spread rapidly
contagious
Mx:
Topical
General
8
Hand Foot and Mouth Disease
Common childhood illness
Mouth sores
fever
sore throat
Rash:• Small red spots
• intra orally
• Palms
• soles of feet
Resolves without scarring within 2 weeks
9