Fever With Cent. Mp Rash

8/13/2019 Fever With Cent. Mp Rash

1/34

FEVER WITH CENTRAL

MACULOPAPULAR RASH

ANBARASAN.S


2/34

RASH

Exanthem

Skin eruption occuring as a symptom of a general

disease

Enanthem Eruptive lesions on the mucous membrane


3/34

EXANTHEM

MACULE a flat skin lesion


4/34

EXANTHEM

PAPULE

a raised lesion


5/34

CLASSIFICATION

Based on Aetiology

Viral exanthems

Bacterial infections (including those that are toxin

mediated) Rickettsial infections

Drug eruptions

Systemic diseases

Rheumatological diseases.

Measles

(Rubeola)Rubella

(German

measles)

Filatow-Dukes

Disease

ErythemaInfectiosum

Roseola

Infantum

Dengue fever

Epidemic

typhusEndemic

typhus

Scrub

typhus

Rickettsial

spottedfever

Lyme

disease

Leptospir

osis

Rat-bite

fever


6/34

CLASSIFICATION

Based on age group

Paediatric

Adult


7/34

General considerations in F+MPR

Primary lesion type, number, and distribution

Mucous membranes involved or spared

Associated signs and symptoms (e.g., fever,pruritus, lymphadenopathy,

hepatosplenomegaly


8/34

FEBRILE ILLNESS AND RASH

Fever + rash + associated signs -----EMERGENCY

Meningococcaemia

Anaphylactic reactions

Toxic epidermal necrolysis (TEN) and Stevens-Johnsonsyndrome (SJS)

Drug reaction with eosinophilia and systemic symptoms(DRESS)

Staphylococcal scalded skin syndrome (SSSS) and toxic shocksyndrome (TSS)

Rickettsial spotted fever.

Fever + with no rash.not urgent to treat


9/34

MEASLES

Paramyxovirus

Incubation period: 10-12days

Kopliksspot: appears 2 days before rash

RASH an erythematous, nonpruritic, maculopapular rash

appears, first behind the ears and at the hairline, andthen spreads inferiorly.

spreads to involve the trunk and extremities, thediscrete macules coalesce.

Infectious period: 1-2days before prodrome to4days after onset of rash


10/34

MEASLES

Kopliksspots - pathognomonic feature


11/34


12/34


13/34

RUBELLA

Togavirus

Incubation period: 14-21 days

RASH A faint pink/red maculopapular rash appears first

on the face, then rapidly spreading inferiorly.

Infectious period: 5-7days before rash to

3-5days after rash


14/34


15/34

ERYTHEMA INFECTIOSUM

Human Parvovirus B19


RASH

bright, fiery, red macular rash across the cheeks

SLAPPED CHEEK OR SUNBURNEDAPPEARANCE

Spread to the extremities in a lacy reticularpattern

Infectious period: up until onset of the rash


16/34


17/34


18/34

EXANTHEM SUBITUM

(Roseola infantum)

Human Herpes Virus6(and 7)

Incubation period: 9 days

RASH: blanching, evanescent, pinkmaculopapular exanthem on the neck and

trunk.

Infectious period: virus is intermittantlyshed

into saliva throughout life; asymp persistent


19/34

SURPRISE

RASH


20/34

DENGUE


RASH

Maculopapular rash which begins on trunk and spread

centrifugally to extremities and face

The rash also may occur on the palms of the hands and

the bottom of the feet, areas frequently spared in many

viral and bacterial infections


21/34

HERMANS RASH

Appears on the third to

fourth day of the fever

Start on the elbows and

knees Spread to the face,

arms and legs

Last for two to three

days


22/34

TYPHUS FEVER

Epidemic typhus

Maculopapular eruption appearing in axillae, spreading

to trunk and later to extremities

Spares face, palms, soles

Blanchable macules to petechiae

Endemic typhus

Maculopapular rash usually sparing palms and soles


23/34


24/34

SYSTEMIC DISEASE

Acute graft-versus-host disease (aGVHD)

rash frequently begins on the hands and feet as

acral erythema and also favours the upper back,

ears, cheeks, and neck.

associated with diffuse erythroderma and

desquamation.

mucous membranes (particularly conjunctiva)may be involved.


25/34

SYSTEMIC DISEASE

Kawasaki disease (mucocutaneous lymph

node syndrome)

rash is typically generalised and maculopapular,

without petechiae.

perineal erythema is particularly pronounced.

rash resembles a viral exanthem.


26/34


27/34

RHEUMATOLOGICAL DISEASES

Juvenile rheumatoid arthritis (JRA or Stills

disease)

eruption of the maculopapular rash associated

with JRA is typically transient (recurring withfever), erythematous, and non-pruritic


28/34


29/34

MORBILLIFORM DRUG REACTION

comprising 95% of all drug-induced skin

reactions.

Most common cause of rash in adults .

Resembles viral exanthems


30/34

CHARACTERISTIC FEATURES OF DRUG

ERUPTIONS

Most reactions develop within 2 to 8 weeks.

The eruption is characteristicallypolymorphic.

Moderate pruritus, a low-grade fever, and general malaisemay be present.

Mucous membranes are typically spared, andlymphadenopathy is mild if present.

The eruption generally fades over 1 to 2 weeks withoutcomplication.

Post-inflammatory desquamation is common and, in the

absence of other findings, does not portend a more seriousdiagnosis such as toxic epidermal necrolysis orstaphylococcal scalded skin syndrome (SSSS). Death isexceedingly rare.


31/34

DRUGS CAUSING MP RASH

Antibiotics

sulphonamides, aminopenicillins, cephalosporins

Anticonvulsants

Carbamazepine, Phenytoin

Other drugs

Lamotrigine, minocycline, dapsone, allopurinol,

abacavir and zalcitabine in HIV-infected patients Epidermal growth factor receptor inhibitors

(EGFRs; e.g., cetuximab)


32/34

30-40 % of patients with HIV infections may

develop skin rash when exposed to sulfa

drugs.(co-trimoxazole)

Infectious Mononucleosis develops macular

erythematous on exposure to ampicillin/

amoxicillin


33/34

DRUG REACTION WITH EOSINOPHILIA

AND SYSTEMIC SYMPTOMS


34/34

Fever With Cent. Mp Rash

Documents

Transcript of Fever With Cent. Mp Rash