Measles in children

Infectious diseases

Clinicals - History

Fact Explanation
Fever - usually resolves after the onset of the rash. But can be prolonged if the patient develops any complication of Measles Viraemia, viral dissemination and systemic inflammatory response. Prodromal symptoms. Fever - usually resolves after the onset of the rash. But can be prolonged if the patient develops any complication of Measles
Viraemia, viral dissemination and systemic inflammatory response. Prodromal symptoms.
Malaise Viraemia, viral dissemination and systemic inflammatory response. Prodromal symptoms. Malaise
Viraemia, viral dissemination and systemic inflammatory response. Prodromal symptoms.
Cough Viraemia, viral dissemination and systemic inflammatory response. Prodromal symptoms. Cough
Viraemia, viral dissemination and systemic inflammatory response. Prodromal symptoms.
Rhinorrhoea Viraemia, viral dissemination and systemic inflammatory response. Prodromal symptoms. Rhinorrhoea
Viraemia, viral dissemination and systemic inflammatory response. Prodromal symptoms.
Conjuctivitis Due to inflammatory response Conjuctivitis
Due to inflammatory response
Rash; A non-pruritic erythematous maculo-papular rash This is the eruptive phase of measles. The rash usually begins in the face and then spreads to involve the rest of the body.
The rash usually lasts one week and fades leaving behind a brownish discoloration.
Rash; A non-pruritic erythematous maculo-papular rash
This is the eruptive phase of measles. The rash usually begins in the face and then spreads to involve the rest of the body.
The rash usually lasts one week and fades leaving behind a brownish discoloration.
Gastrointestinal symptoms: nausea, vomiting, diarrhea Viraemia, viral dissemination and systemic inflammatory response. Gastrointestinal symptoms: nausea, vomiting, diarrhea
Viraemia, viral dissemination and systemic inflammatory response.
Exclude possible immunodeficiency e.g. Diabetes mellitus, HIV infection, Immunosuppressive therapy Risk of developing severe life threatening complications of measles, such as pneumonia or acute encephalitis. Exclude possible immunodeficiency e.g. Diabetes mellitus, HIV infection, Immunosuppressive therapy
Risk of developing severe life threatening complications of measles, such as pneumonia or acute encephalitis.

Clinicals - Examination

Fact Explanation
Fever Viraemia and systemic inflammatory response. Fever
Viraemia and systemic inflammatory response.
Koplik's spots - Whitish spots that occur on the buccal mucosa. they appear prior to occurrence of the rash and are pathognomonic of measles Inflammatory response. Koplik's spots - Whitish spots that occur on the buccal mucosa. they appear prior to occurrence of the rash and are pathognomonic of measles
Inflammatory response.
Rash - maculo-papular, generalized, non-pruritic Eruptive phase of the disease. Rash - maculo-papular, generalized, non-pruritic
Eruptive phase of the disease.
Lymphadenopathy Due to systemic inflammatory response. Lymphadenopathy
Due to systemic inflammatory response.
Splenomegaly Due to systemic inflammatory response. Splenomegaly
Due to systemic inflammatory response.
Respiratory system - Pneumonia may complicate Due to primary complication of Measles or secondary bacterial infection. , Respiratory system - Pneumonia may complicate
Due to primary complication of Measles or secondary bacterial infection. ,
Central nervous system - level of consciousness: drowsiness to coma Measles may be complicated by acute encephalitis. Central nervous system - level of consciousness: drowsiness to coma
Measles may be complicated by acute encephalitis.

Investigations - Diagnosis

Fact Explanation
Immunofluorescent staining for measles antigen from respiratory secretions or throat swabs Specific diagnosis by demonstration of measles virus. Immunofluorescent staining for measles antigen from respiratory secretions or throat swabs
Specific diagnosis by demonstration of measles virus.
Microscopic examanition of respiratory secretions for multinucleated giant cells Due to inflammatory response. Microscopic examanition of respiratory secretions for multinucleated giant cells
Due to inflammatory response.
Culture of measles virus in respiratory secretions or urine Virus present in respiratory secretions and in urine. Culture of measles virus in respiratory secretions or urine
Virus present in respiratory secretions and in urine.
Polymerase Chain Reaction (PCR) to demonstrate measles virus in respiratory secretions or urine Virus present in respiratory secretions and in urine. Polymerase Chain Reaction (PCR) to demonstrate measles virus in respiratory secretions or urine
Virus present in respiratory secretions and in urine.
Enzyme Immunoassay (EIA) of blood for IgM and titres of IgG IgM present few days after onset of rash, IgG titre progressively rises after 1-2 weeks. Enzyme Immunoassay (EIA) of blood for IgM and titres of IgG
IgM present few days after onset of rash, IgG titre progressively rises after 1-2 weeks.

Investigations - Management

Fact Explanation
Enzyme Immunoassay IgG levels With resolution of acute illness, titer of IgG should reduce. Enzyme Immunoassay IgG levels
With resolution of acute illness, titer of IgG should reduce.
Chest X ray Measles may be complicated by pneumonia due to Measles virus or due to secondary bacterial pneumonia. Chest X ray
Measles may be complicated by pneumonia due to Measles virus or due to secondary bacterial pneumonia.
Non contrast CT scan of Brain Measles encephalitis. Non contrast CT scan of Brain
Measles encephalitis.
Lumbar puncture Measles encephalitis. Lumbar puncture
Measles encephalitis.
Electroencephalogram (EEG) Measles encephalitis. Electroencephalogram (EEG)
Measles encephalitis.
White cell count Asses for Lymphopenia or Neutropenia. White cell count
Asses for Lymphopenia or Neutropenia.

Management - Supportive

Fact Explanation
Supportive care To Prevent further deterioration due to acute illness. Supportive care
To Prevent further deterioration due to acute illness.

Management - Specific

Fact Explanation
Intra venous antibiotics For management of pneumonia or otitis media. Intra venous antibiotics
For management of pneumonia or otitis media.
Observation for increased intracranial pressure When complicated by measles Encephalitis. Observation for increased intracranial pressure
When complicated by measles Encephalitis.
Vitamin A supplementation In severe measles. Vitamin A supplementation
In severe measles.
Ribavirin In immunocompromised patients. Ribavirin
In immunocompromised patients.
Measles vaccine - either separate or combined as Measles, Rubella or Measles, Mumps, Rubella To prevent acute measles infection, to prevent Sub-acute Sclerosing pan-encephalitis (usually in children under 2 years old who haven't been vaccinated) Measles vaccine - either separate or combined as Measles, Rubella or Measles, Mumps, Rubella
To prevent acute measles infection, to prevent Sub-acute Sclerosing pan-encephalitis (usually in children under 2 years old who haven't been vaccinated)

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