Epidemiology


Etiology


Pathophysiology


Clinical features


See Congenital rubella infection

CharacteristicRubellaMeasles
Severity of IllnessGenerally milder diseaseMore severe with higher complication rates
Rash CharacteristicsFine, pink maculopapular rash starting on face; lasts ~3 daysErythematous maculopapular rash starting at hairline; more confluent; lasts 5-7 days
Prodromal SymptomsMinimal; mild fever, malaise, lymphadenopathyProminent with high fever, cough, coryza, conjunctivitis (“3 Cs”)
Pathognomonic SignsPosterior auricular and suboccipital lymphadenopathyKoplik’s spots (white spots on buccal mucosa)
Congenital EffectsSignificant risk of congenital rubella syndromeNo specific congenital syndrome; may cause pregnancy complications
InfectivityModerately contagiousHighly contagious (one of the most contagious diseases)
ComplicationsRare in children; arthritis in adults; congenital defectsPneumonia, encephalitis, SSPE, high mortality in malnourished children

Diagnostics


Childhood exanthems

DiseasePathogenClassic Presentation & Buzzwords
MeaslesMeasles virus4 C’s (Cough, Coryza, Conjunctivitis, Koplik spots).
Rash: Face Body (Confluent).
Assoc: Vitamin A deficiency.
RubellaRubella virusPost-auricular LAD.
Rash: Face Body (spares 3 days, non-confluent).
Assoc: Congenital (PDA, cataracts, deaf), Adult arthritis.
RoseolaHHV-6High fever breaks Rash appears.
Rash: Trunk Face.
Assoc: Febrile seizures.
Fifth DiseaseParvovirus B19”Slapped Cheek” Lacy/Reticular body rash.
Assoc: Aplastic crisis (Sickle Cell), Hydrops fetalis.
VaricellaVZV”Dewdrop on a rose petal”.
Lesions in different stages of healing. t
Rash: Trunk Extremities.
Scarlet FeverStrep pyogenesSandpaper rash, Strawberry tongue, Circumoral pallor.
Assoc: Strep throat, Desquamation (palms/soles).

Fever-rash relationship

  • Measles (Rubeola): Fever first (with cough, coryza, conjunctivitis) → Rash appears 3-5 days later, spreading from head to toe.
  • Rubella (German Measles): Low-grade fever → Rash appears 1-2 days later, spreading quickly from head to toe.
  • Scarlet Fever: Fever and sore throat begin together → “Sandpaper” rash appears 1-2 days later.
  • Erythema Infectiosum (Fifth): Low-grade fever/prodrome resolves → “Slapped cheek” rash appears days later.
  • Roseola Infantum (Sixth): High fever for 3-5 days → Fever breaks → Rash appears after the fever is gone.
  • Varicella (Chickenpox): Fever and vesicular rash appear at the same time (lesions in various stages).
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Treatment