TASHKENT MEDICAL ACADEMY Infectious and children infectious diseases department Theme: Early and Comparative diagnosis of diseases with the syndrome of exanthema Lecturer:

Exanthema –rashes on the skin Identification of Primary Skin Lesions

MACULE Circumscribed area of change in normal skin color, with no skin elevation or depression; may be any size

PAPULE Solid, raised lesion up to 0.5 cm in greatest diameter

NODULE Similar to papule but located deeper in the dermis or subcutaneous tissue; differentiated from papule by palpability and depth, rather than size

PLAQUE Elevation of skin occupying a relatively large area in relation to height; often formed by confluence of papules

VESICLE Circumscribed, elevated, fluid-containing lesion less than 0.5 cm in greatest diameter; may be intraepidermal or subepidermal in origin

BULLA Same as vesicle, except lesion is more than 0.5 cm in greatest diameter

Measles Measles an infectious viral disease causing fever and a red rash on the skin, typically occurring in childhood.

Symptoms Bloodshot eyes Cougf &fever Light sensitivity (photophobiya) Muscle pain & rash Usually appears 3-5 days after the first signs of being sick May last 4-7 days Usually starts on the head and spreads to the other areas , moving down the body

Rash may appear as flat,discolored areas(macules)and solid,red,raised areas(papules)that later join together Itchy Redness and irritation of the eyes(conjunctivitis) Runny nose Sore throat Tiny white spots inside the mouth (Koplik’s spots)

Viral culture (rarely done) Tests&diagnosis Measles serology Viral culture (rarely done)

Treatment Acetaminophen(tylenol) Bed rest Humidified air There is no specific treatment for the measles.

SCARLET FEVER An acute infection by group A beta-hemolytic streptococci that produce an erythrogenic exotoxin.

The rash - finely punctate erythema on the superior trunk and face two to three days after the onset of illness spreading to the extremities.

White, with red, swollen papillae (white strawberry tongue) White, with red, swollen papillae (white strawberry tongue). By the fourth or fifth day, it becomes bright red (red strawberry tongue).

Tests Blood analysis neytrofilyos Dik test

Treatment Penicillin Tetracycline Bed rest

Rubella Rubella Rubella (German measles) is a disease caused by the rubella virus. Rubella is usually a mild illness. Most people who have had rubella or the vaccine are protected against the virus for the rest of their lives.

Rubella is also called as 3 day Measles or German Measles Rubella is also called as 3 day Measles or German Measles. Family – Togaviridae Genus - Rubivirus In general belong to Togavirus group– RNA virus Diameter 50 – 70 nm Enveloped Spherical Virus carry hemagglutinin Virus multiply in the cytoplasam of infected cell.

begins around the fourth febrile day, with discrete lesions spreading from the hairline downward, sparing the palms and soles. : Koplik's spots in the oral mucosa.

The exanthema: lasting four to six days, fading gradually in order of appearance, leaving a residual faint desquamation.

Isolation and Identification of virus Nasopharyngeal or throat swabs taken 6 days prior or after appearance of rash is a good source of Rubella virus Using cell cultured in shell vial antigens can be detected by Immunofluresecentetmehods

Tests Serology In Rubella Hemagglutination inhibition test for Rubella is of Diagnostic significance ELISA tests are greater importance A raise in Antibody titers must be demonostrated between two serum samples taken at least 10 days apart. Or Detection of Rubella specific IgM must be detected in a single specimen.

Treatment No specific treatment or Antiviral treatment is indicated. However Laboratory proved and clinically missed Rubella in the Ist 3-4 months of pregnancy is associated with fetal infections.

Meningococcemia NEISSERIA MENINGITIDIS (MENINGOCOCCUS) Gram Stain - Negative Anaerobic - CO2 enhances growth Extracellular Features - diplococci - “coffee bean” or “kidney bean” appearance Colonies - small, transparent on chocolate agar

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