Causative Incubation Rash Morphology &

Disease Transmission History Infectivity Unique features Complications Treatment

organism period Distribution
First day: Fever & Malaise with 3Cs 5 days prior to onset of Maculopapular erythematous Koplik's spots on On 2nd day of Otitis media (m.c) Supportive (Antipyretic & hydration)
(cough, coryza, and conjunctivitis) symptoms until 5 to 6 days rash appear on forehead illness Opposite molars
Measles Contact with
Para-myxovirus 10-14 days Then Koplik's spot after the onset of rash downward, after three days, Encephalitis Vit A if admitted
(Rubeola) droplets Confers lifelong immunity Disappear coincident with the Pneumonia (m.c of death)
start to fade in reverse order
(discrete macular lesions) appearance of the rash Antbiotics if Complications occur
Then On 3-5 day: Rash appears Vaccine available Death (1:5000)
Prodrome 1-6 days Before rash: < 16 wk: Cataract, deafness, IUGR, Cardiac,
Few days before and 5 to 7
headache, malaise, sore throat, Post-auricular Lymphadenopathy Encephalitis
Rubella (aka; days after the onset of the Transient pink or red first on
Contact with coryza, and fever. Disappear 24 hours
German Measles Rubella 14-21 days rash face and Neck, then trunk and Supportive
droplets after rash 16-20 wks: min risk of deafness
or third disease) limbs
Tender Post-auricular Forscheimer spots
Vaccine available >20 wks> no documented risk
Lymphadenopathy
Roseola infantum 6 mo - 3 years Pink or rose colored macules
During whole period of Encephalitis (very rare) Not necessary
(aka; exanthem Herpesvirus 6 or Abrupt high fever upto 41 C First on Trunk, then arms &
Saliva 10-15 days Last for 3-4 days disease & may be even neck
subitum or 6th 7
disease) before pyrexia Febrile seizure Prognosis is Excellent
Rash when fever subside Last for 1-2 days
Erythema Contact with Mild prodrome Biphasic: Rash is intensely red Fetal lose in 10%
infectiosum aerosolized Arthritis common in adults but rare in Not infectious once rash on the face (4-5 days), then
parvovirus B19 4-14 days Slapped-cheek appearance May recur with Temp changes Supportive
(aka; fifth respiratory children appears A reticular (netlike)
disease) droplets Mainly 4-10 years of age maculopapular eruption Aplastic crisis in SCA
Fever, chills, malaise, and sore throat, Begins on the chest and Early: Ear, tonsil, throat and meningeal
Oral penicillin VK for 10 days
Group A strep followed within 12 to 48 Can be infectious for 2 to 3 spreads rapidly, usually within infection
Scarlet fever Respiratory
infection (strept 1-7 days hours by a distinctive rash weeks after the symptoms Sandpaper-like Late: ARF or GN
(aka; scarlatina) droplets Facial flushing, perioral pallor
pyogenes) appear if not treated Single I.M benzathine pencillin 1.2
2-8 years of age >> Strawberry tongue
Erythema marginatum may be seen in 10%.
Highly contagious in Appearance of lesions in ALL Encephalitis / meningitis Supportive
Low-grade fever, malaise, and three stages in one region
Direct contact prodromal and vesicular Pneumonia (adult) Avoid Salicylates
Varicella (aka;
Varicella Zoster 14-21 days headache stage till they dry (Crops, clusters), appear 3-4 Thrombocytopenia
chickenpox) Air: sneezing, Acyclovir (if e/in 24 hr of rash)
Vaccine available (live days after symptoms Cellulitis
coughing < 10 years of age
attenuated) Start on the trunk and Face Reactivation > Shingles VariZIG Ig
Coxsackievirus < 5 years of age (m.c < 3) Erythematous macule Supportive
Viral meningitis
Direct contact Oral: Painful Vesicles & ulcer Symptomatic
HFM disease A16 or
Low grade fever, anorexia, malaise, H & F: non-tender vesicles
enterovirus 71 Meningoencephalitis Diligent hand washing
URTI (2-3 days) THEN Rash Lesions resolve over 4 to 7 days
Sneezing First 5 days after
3-6 days Myocarditis
symptoms start Small whitish ulcers, typically
Coxsackievirus located on the soft palate and Viscous lidocaine should not be used
Herpangina Fever, mouth pain, and oral ulcers
group A subtype posterior pharynx, without in children
Coughing Sepsis
accompanying skin lesions

HSV-1 1) Gingivostomatitis: Persists for life in a latent Umbilicated vesicles that are
Oral acyclovir 200 mg 5x1x7
Orofacial (m.c) Fever, malaise, and vesicles form extremely painful
Liver, lung, CNS Herpes labialis if reactivate
Viral shedding may occur Recurrent: 400 mg 5x1x5
& genitalia Oral secretions less severe if reactivate
from an asymptomatic source
In childhood 2) Genital Herpes:
Oral acyclovir 200 mg 5x1x7-10
Lays latent in Painful vesicles and ulcers
sensory ganglia Fever, malaise & dysurea Recur: 200x5x5
3) HSV-1 Encephalitis:
Temporal lobe
Acute onset
HSV infection 2-14 days Focal deficit Diagnosis:
70% mortality if not treated C/S, PCR or DFA = difinitive IV Acyclovir 10 mg/kg x3x 14-21 days
4) HSV-2 Meningitis: PCR is more sensitive than C/S
Benign Serology: acute or reactivation
more in women PCR for CSF
5)HSV-2 neonatal encephalitis High WBC (Lymphocytes)
HSV-2 6) Herpetic whitlow: Normal CSF in rare cases
During childbirth Oral acyclovir 200 mg 5x1x7
Genitalia (m.c) Painful vesicles (immunocompromised)
Other systems 7) Ocular herpes: Resending CSF PCR in 72 hours
Usually in adults keratitis, conjunctivitis, and acute CT/MRI of brain is suggestive & Oral acyclovir 400 mg 5x1x7
Sexual contact
Neonate retinal necrosis may be NAD early in course
Fever >/= 5 days + 4 of the following (CRASH) High WBC, high platelets Admission
Vasculitis of Peaks at age 18 to 24 months, 1) Conjunctivitis: Bilateral & nonexudative CRP > 3, ESR > 40
Palmar lesions: Diffuse IVIG; 2 g/kg over 10 to 12 hrs
small &medium with most cases occurring by 2) Rash: Polymorphous, generalized Albumin < 3
erythema, may later
KAWASAKI’S vessels - age 10 years and the majority 3) Adenopathy: cervical node more than one > 1.5 cm High ALT
desquamate (see measles) Coronary artery aneurysm 1:5 patient
DISEASE unknown of patients being seen by age 4) Straberry tonge: erythema, or cracked and red lips Pyuria Aspirin (initially 80 to 100 mg/ kg
5 years 5) Hands and feet: erythema and swelling Anemia for age daily divided QID till afebrile

Echocardiography

Dr. Sadiq Ameen