Thursday, January 29, 2015


A 5 year old child was exposed to this disease 10 days ago. He presents initially with fever, cough, runny nose, malaise, and loss of appetite. The mom is worried about flu, though no one around him has gotten the flu. On exam, you note some conjunctivitis. You're not sure what it is, but you feel it's likely a URI and send the patient home.

The patient returns 3 days later with the rash shown above. It began on the face and spread cephalocaudally and centrifugally to involve the neck, upper trunk, lower trunk, and extremities. The rash on the face has become confluent. Luckily, the rash indicates that the child will get better within 48 hours.

Challenge: What's the diagnosis?

Image is in the public domain.


RaH said...

Hello, this is a maculo-papulous Exanthem likely in Measels infection.
The rash is typically a sign of healing. An Enathem might also be present with small round dots on mucosae. Koplick sign
Only a few hundred cases of measels are reported in the Americas each year. The MMR-vaccine helps!
Diagnosis in clinical: 3 days of fever with one of the 3 C's cough, coryza, conjunctivitis, Koplik spots is also diagnostic

Craig Chen said...

exactly right! measles is seeing a recurrence due to all the non-vaccinators.

This is measles (rubeola) caused by a paramyxovirus.

Sources: UpToDate; Wikipedia.