1. Exanthematous diseases - Etiology
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Diseases Etiology
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Measles Morbillivirus (RNA)
(Rubeola) (Paramyxoviridiae family)
(5-10 yr)
Rubella Rubivirus (RNA)
German measles (Togaviridiae family)
(6-9 yr)
Erythema infectiosum Parvovirus B19 (1995)
(2-12 yr) Erythrovirus genus
(Parvoviridiae family)
Exanthema subitum HHV-6 (1986) and HHV-7 (1990)
(Roseola)
(<3 yr)

2. Exanthematous diseases - Source and
Spreading
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Diseases Source Spreading
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Measles man droplet, airborne
(Rubeola)
Rubella man droplet, urine,
(German measles) transplacental
Erythema infectiosum man droplet, blood
(Fifth disease)
Exanthema subitum man droplet
(Roseola)

3. Exanthematous diseases - Communicability and
Season
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Diseases Communicability Season
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Measles 5 d before rash winter, spring
5 d after rash
Rubella 7 d before rash winter, spring d after rash
Erythema infectiosum unknown spring
Exanthema subitum unknown throughout the year

4. Exanthematous diseases – Clinical manifestation
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Diseases Clinical manifestation
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Measles Incubation time: 8-12 days.
cough, coryza, conjunctivitis, enanthema, Koplik’s spots, leucopenia; confluent, maculopapules, erythematous exanthems
Rubella Incubation: days.
50 % asymptomatic; lymphadenopathy, low-grade fever, malaise, leucopenia; polyarthralgia, polyarthritis; discrete, maculopapules,
pink exanthemas
Erythema Incubation: 4-28 days.
infectiosum fever (<30%), MURTI; Rash in three phases:
1) slapped cheek;
2) maculopapular, lace-like (arms-trunk-thigh)
3) fluctuating rashes
Exanthema Incubation: 7-14 days.
subitum fever (3 d), MURTI; Rash (2 d); Irritability, febrile seizures, mononucleosis-like illness. Fever without rash.

5. Exanthematous diseases – Diagnosis and treatment
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Diseases Diagnosis Treatment
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Measles Serology Supportive
Virus isolation Vitamin A
Rubella Serology Supportive
Virus isolation
Erythema infectiosum Serology Supportive
PCR
Exanthema subitum Serology Supportive

6. 9 - TSS Fever: temperature 38.9°C ( 102.0°F)
Rash: diffuse macular erythroderma
Desquamation: 1–2 wk after onset, particularly on palms, soles, fingers, and toes
Hypotension: systolic pressure 90 mm Hg for adults; lower than fifth percentile for age for children younger than 16 years of age; orthostatic drop in diastolic pressure of 15 mm Hg from lying to sitting; orthostatic syncope or orthostatic dizziness

7. TSS Multisystem organ involvement: >3 of the following:
Gastrointestinal: vomiting or diarrhea at onset   
Muscular: severe myalgia or CPK greater than twice the upper limit of normal  
Mucosal hyperemia vaginal, oropharyngeal, or conjunctival   
Renal: CN or Cr greater than twice the upper limit of normal
Hepatic: SeBi, GOT, GPT greater than 2x the upper limit of N
Hematologic: Thrombocytopenia  
CNS: disorientation or alterations in consciousness without focal neurologic signs