1. Board Review
ID Rapid Fire

2. Fever, photophobia, runny nose, dry cough.
Conjunctivitis
Koplik spots
Fever, photophobia, runny nose, dry cough.
Rubeola
Measles - Rubeola

3. Rubeola Measles! Macular papular rash – head down Koplik spots
Conjunctivitis
Fever, cough, coryza
Most contagious 5 days before and 5 days after rash
Think if patient is not immunized

4. Rubella Forchheimer spots
Low Grade Fever, Malaise, LAD, Fine Maculopapular Rash, Arthritis

5. Rubella German Measles Low grade fever, rash, occipital LAD
Mild viral illness unless you are
PREGNANT

6. Varicella
Fever, runny nose then develops this itchy rash. Started on trunk and then spread all over.
Varicella

7. Complications of Varicella

8. Varicella Rash starts at trunk and spreads out
Superficial vesicles, pustules and crusts in varying stages
Vesicles with red halos
Contagious few days before the rash, until it crusts (7-10 days)
Complications
Secondary skin infections
Disseminated
Viremia, pneumonia, encephalitis

9. Newborns and Varicella
A baby is considered exposed if:
Mom gets chickenpox 5 days before to 2 days after delivery
Treatment
VZIG

10. Fever, sore throat, runny nose.
Adenovirus
Adenovirus

11. Adenovirus Conjunctivitis, pharyngitis, adenopathy
Also cause GI illness
More common in summer
Preauricular LAD

12. Coxsackievirus – Hand Foot Mouth
My child has bumps and they hurt!!
Coxsackievirus

13. Fifth Disease – Parvo B19
Parvo B19 – Fifth Disease, Erythema Infectiosum

14. Fifth Disease Erythema infectiosum – Parvovirus B19
Starts with fever, sore throat, runny nose, HA, malaise
Then get “slapped cheek” rash
Rash can spread to extremities
Diagnosis – clinical (can get IgM titers)

15. I had fever and then got this rash…
ROSEOLA
Roseola

16. Roseola – HHV ?? HHV 6 3-5 days of high fever
Rash after fever resolves
Can be associated with febrile seizures
Diagnosis - Clinical

17. Mononucleosis
Fever, fatigue, pharyngitis, LAD, splenomegaly
EBV

18. EBV Acute, self-limited Oral contact – “kissing disease”
Fever, fatigue, pharyngitis, LAD, splenomegaly
Anterior cervical LAD – most common
Labs
Atypical lymphs, +heterophile antibodies
Complications
Aseptic meningitis, Guillain Barre, pericarditis

19. CMV Acquired Congenital Presents like mono
Treat immunosuppresed - Gancyclovir
Congenital
HEARING LOSS - sensorineural
Mental retardation
Hepatomegaly
Chorioretinitis
Cerebral calcifications (periventricular)
Thrombocytopenia (blueberry muffin)
Diagnosis: urine culture in first 3-4 weeks of life - definitive

20. Herpetic Gingivostomatitis
Herpes

21. Herpes Simplex Virus HSV-1 – most common HSV-2 – usually genital
Affects skin and mucus membranes
HSV-2 – usually genital
Presentation
Grouped vesicular lesions, mucuosal inflammation
Diagnosis
Clinical
Tzank smear – multinucleated giant cells
Culture
PCR
DFA

22. Herpetic Whitlow
Herpetic witlow

23. Ocular Herpes Call Optho!!
Keratoconjunctivitis – can cause permenant visual impairment.
Ocular herpes

24. High fever, pain, and history of excema
Excema herpeticum
Excema Herpeticum – lesions can develop into pustules and can become hemorrhagic. Treat – IV Acyclovir

25. More Herpes
Herpes labialis

26. Zoster
zoster

27. Mumps
THINK: If the question says immigration, adoption or no vaccines!!!
Mumps

28. Mumps Paramyxovirus Usually have bilateral parotid gland swelling
Fever, HA, malaise
Can also have swelling of testicles
Complications:
Meningitis/encephalitis
Orchitis – doesn’t usually result in infertility
Pancreatitis

29. Congenital Rubella Cataracts Heart Disease – PDA
Sensorineural deafness
HSM
Thrombcyotopenia – purpura
Blueberry Muffin Rash – dermal erythropoiesis
SGA
Myocarditis
Cong Rubella

30. Neonatal Herpes I am doing well until DOL 4 – develop these lesions…

31. Congenital HSV Think – seizure in newborn
Esp if temporal lobe
Usually mom has no history of lesions
Sepsis, meningitis, seizures
Negative gram stain - elevated WBC, elevated protein
Diagnosis – HSV PCR

32. Cong Syphillis If untreated:
Infants – SGA, HSM, hyperbilirubinemia, thrombocytopenia, LAD
If untreated:
Snuffles, demineralization of bones, horse cry, saddle nose, Hutchinson teeth, Keratitis, Deafness, Sabre shin, frontal bossing, clutton joints, mental retardation
Cong Syphillis

33. 13 year old with thrush and candidal rash
AIDS – thrush and candidal diaper
CHECK FOR HIV
*also think about DM, but this is ID Board Review.

34. Bactrim for prophylaxis “Ground Glass”
PCP in AIDS patient
Hypoxia
Bactrim for prophylaxis
“Ground Glass”
PCP in AIDS

35. Molluscum – HIV patient

36. Kaposi Sarcoma
Kaposi sarcoma

37. HIV Think when you have chronic nonspecific symptoms Testing
Wt loss, fever, night sweats, FTT, thrush!
Testing
Start with ELISA
Confirm with Western Blot

38. Baby exposed to HIV
Dramatically reduce transmission by AZT treatment during pregnancy
Testing – DNA PCR
Birth
2 months
4 months
6 months

39. Rabies Fox, bats, raccoons, skunks, ferrets Raccoon is common in US
If baby in room with bat – have to treat
Treatment
Don’t need to treat if can watch animal
HRIG – if highly suspect
If haven’t had previous immunization
Vaccine – 5 doses

40. RSV Most common cause of bronchiolitis in infants
Infant with wheeze, retractions, tachypnea, fever, and URI symptoms
CXR – diffuse infiltrates and hyperinflation
Diagnosis
Treatment
Supportive
Albuterol trial
What is the best way to prevent?
Hand washing

41. Rotavirus Fever, watery diarrhea, and vomiting
Commonly causes dehydration
Diagnosis
Antigen test of stool
Treatment
supportive

42. THE END!!