TASHKENT MEDICAL ACADEMY Infectious and children infectious diseases

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, fluidcontaining 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 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)

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 betahemolytic 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). 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 (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. 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 Ig. M 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 - CO 2 enhances growth • Extracellular • Features - diplococci - “coffee bean” or “kidney bean” appearance • Colonies - small, transparent on chocolate agar

Thank You…