The diseases with the exanthemas syndromes

Июль 29, 2022

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The diseases with the exanthemas syndromes

Содержание

2. Measles (Morbilli) The pathogenic agent causing measles is the paramyxoviruses. The measles virus is very unstable
3. Epidemiology The source of infection - a sick person Infectivity is greatest in the initial catarrhal
4. The virus is expelled from the organism in the secretion of the mucous membranes The susceptibility
5. Pathogenesis The portal of entry is the mucous membrane of the respiratory tract, and the conjunctiva
6. The process in the bronchitis and bronchiolitis has a tendency to penetrate and format interstitial pneumonia
7. Clinical manifestations The period of measles - incubation period – catarrhal period – eruptive period –
8. Catarrhal period a rise in temperature, headache, rhinitis, and cough general malaise, adynamia, loss of appetite,
9. Belsky-Filatov-Koplik's spots on the buccal mucosa on the line of opposition of the molar teeth, and
10. The eruptive period stage begins with a new rise of temperature first elements of the rash
11. Elements of the rash look like pink papules of a soft consistency, the size of a
12. Period of pigmentation subsiding rash becomes less prominent and assumes a cyanotic tinge; its elements, gradually
13. Blood at the end of the incubation period, the blood picture shows mild leukocytosis and neutrophilosis
14. Classification Typical form: – mild – moderately severe -- severe. Atypical forms: – measles with a
15. Mitigated form is in children who underwent serum prophylactic immunization the incubation period is protracted to
16. Complications Laryngitis - of measles croup Pneumonia is one of the most common complications in measles:
17. Nervous complications are serous meningitis, encephalitis
18. Diagnosis Measles must be identified as early as possible. The diagnosis is based on clinical symptoms,
19. Specific diagnosis The diagnosis is verified by a serological test - hemagglutina-don-inhibition test, neutralization and the
20. Treatment organized hygienic conditions, nursing care of the patient and protection from secondary infections hospitalized when
21. Treatment hospitalized when they are severe and complicated; home conditions are unsatisfactory, or it is impossible
22. Prophylaxis Carantin is during 21 days after contact Gamma-globulin is only used for prophylactic purposes in
23. Rubella The agent that causes rubella is a microvirus, it contains a single-stranded RNA, and is
24. Epidemiology The source of infection is a sick person, who probably becomes infective a few days
25. Clinical Manifestations incubation period lasts 15-21 days, sometimes up to 24 days slight rise in temperature
26. Rash the rash invades the face and neck, and covers the whole body within a few
27. Blood counts demonstrate leukopenia, lympho, and numerous plasma cells (10-15 %) Complications are exceptionally rare :
28. Clinical manifestations of congenital rubella: “Сongenital rubella syndrome" are : cataract, cardiac defects, deafness
29. Congenital rubella microcephalic hydrocephalus, deafness, cataract, retinopathy, microphthalmia, glaucoma, cardiac defects A risk of various embryopathies
30. no treatment is required patient should be isolated until the 5th day from the outbreak of
31. Scarlet Fever Scarlet fever is an acute infectious disease, characterized by lesions of oropharynx with submaxillary
32. pathogen of scarlet fever is a β-hemolytic Streptococcus group A have considerable stability to the influence
33. Epidemiology Scarlet fever is anthroponozic The source of infection is a child with scarlet fever or
34. Pathogenesis The principal portal of entry in scarlet fever is mucous membrane of oropharynx The infection
35. The toxic syndrome is the result of influence of the toxic substances produced by the hemolytic
36. The allergic syndrome is caused by the sensitizing substances of hemolytic streptococcus, which are proteins reaches
37. Clinical Manifestations The incubation period for scarlet fever is 2 to 7 days The disease is
38. Tonsillitis Scarlatinal tonsillitis may be catarrhal, follicular or necrotic Tonsillitis is accompanied by regional lymphadenitis The
39. Tongue During the first 1 or 2 days the dorsum has a white "fur coat", and
40. Exanthema It becomes generalized very rapidly. Patient face is typical in scarlet fever - cheeks are
41. Rash is more intense in skin folds such as the axillae, cubital, inguinal, popliteal, and also
42. Tiny petechiae occur in the creases of the folds of the joints and form transverse lines
43. initially on the face on the second week as fine branny flakes desquamation skin of the
44. Cardiovascular changes In acute period of scarlet fever tachycardia, increased blood pressure Bradycardia, arrhythmia, decreasing of
45. Classification Typical: mild, moderate, severe Atypical (extrabuccal forms) - they are characterized by a short-term incubation
46. Complications early one (first week) - septic complications are tonsillitis, lymphadenitis, otitis media allergic ones the
47. Treatment Hospitalization takes Severe course of scarlet fever with various complications. Children from boarding schools and
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Measles (Morbilli)
The pathogenic agent causing measles is the paramyxoviruses.
The

measles virus is very unstable and is soon destroyed outside the human body.

Слайд 3

Epidemiology
The source of infection - a sick person
Infectivity is greatest in

the initial catarrhal stage and during the fourth days after the appearance of the rash
With complications pneumonia infectivity during the tenth days after the rash
The aerial-droplet route usually conveys infection

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The virus is expelled from the organism in the secretion of

the mucous membranes
The susceptibility of humans to measles is very high (susceptibility index 0.96)
Infants under three months of age are immune to measles

Epidemiology

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Pathogenesis
The portal of entry is the mucous membrane of the respiratory

tract, and the conjunctiva
The principal pathological changes attending measles are inflammatory processes in the nasopharynx, respiratory organs, intestinal, and skin
The Belsky-Filatov-Koplik spots are the result of an inflammatory process with small foci of degeneration of the epithelium buccal and labial mucosa

Слайд 6

The process in the bronchitis and bronchiolitis has a tendency to

penetrate and format interstitial pneumonia
In the central nervous system format serous meningitis and encephalitis
The reactivity of the child's organism during measles is expressed in the condition known as measles anergy: positive tuberculin reaction disappears, the immune body’s falls, the complement decreases

Pathogenesis

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Clinical manifestations
The period of measles
- incubation period
– catarrhal period
– eruptive period
– period of pigmentation
The incubation

period of measles is usually from 9 to 17 days. In children who have been vaccinated, or were given blood or plasma transfusions, the incubation period may even he as long as 21 days

Слайд 8

Catarrhal period
a rise in temperature, headache, rhinitis, and cough
general malaise,

adynamia, loss of appetite, and insomnia
conjunctivitis expresses itself in conjunctiva hyperemia and photophobia and blepharospasm
enanthema - red irregular spots varying in size can be seen on the mucosa of the soft, and in part of the hard, palate

Слайд 9

Belsky-Filatov-Koplik's spots
on the buccal mucosa on the line of opposition

of the molar teeth, and less commonly on the lip inner surfaces and on the gums, occasionally on the conjunctiva
element looks tike a whitish papule, the size of a poppy-seed, surrounded by a narrow band of hyperemia, or areola

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The eruptive period
stage begins with a new rise of temperature
first

elements of the rash are found behind the ears and in the centre of the face
it spreads rapidly over the whole face, neck, and upper part of the chest.
On the second day, the exanthema rapidly spreads over the trunk
and the proximal parts of the limbs, and on the third day covers the limbs

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Elements of the rash
look like pink papules of a soft

consistency, the size of a grain of millet
soon adjacent maculopapules become confluent, forming large blotches of irregular outline
maculopapular elements have a tendency to fuse further
rash exanthem persists for three days

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Period of pigmentation
subsiding rash becomes less prominent and assumes a

cyanotic tinge; its elements, gradually fading, leave spots of a light-brown pigmentation
persists for one or two weeks

the rash on the face fades on the third day when it appears on the extremities

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Blood
at the end of the incubation period, the blood picture

shows mild leukocytosis and neutrophilosis
at the end of the catarrhal stage leukopenia and neutropenia,
and at the eruptive stage leukopenia, often with a relative neutropenia, eosinopenia and thrombopenia

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Classification
Typical form:
– mild
– moderately severe
-- severe.
Atypical forms:
– measles with a toxic
– abortive
– rudimentary course
-- mitigated

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Mitigated form
is in children who underwent serum prophylactic immunization
the incubation

period is protracted to a maximum of 21 days
the initial and eruptive periods are shortened
catarrhal symptoms in the mucous membrane are usually mild or absent
the enanthema and Belsky-Filatov-Koplik's spots may not appear
rash is usually sparse and sometimes is represented by few macularpupular elements
no complications issues

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Complications
Laryngitis - of measles croup
Pneumonia is one of the most

common complications in measles: early pneumonia (in the catarrhal stage), secondary infection (pneumococcal, staphylococcal and streptococcal)
Complications of the alimentary tract are stomatitis (gangrenous stomatitis or noma), dyspepsia is common, colitis
Catarrhal otitis, purulent otitis, blepharitis and keratitis

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Nervous complications are serous meningitis, encephalitis

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Diagnosis
Measles must be identified as early as possible.
The diagnosis is

based on clinical symptoms, taking into account the epidemiological anamnesis
In the catarrhal stage can resemble influenza and other respiratory viral infections
During the eruptive stage – Rubella; Scarlet fever, Serum rash, Drug rash

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Specific diagnosis
The diagnosis is verified by a serological test - hemagglutina-don-inhibition

test, neutralization and the complement-fixation test. The increasing titer (4 times and over), as determined during a repeated test in 7-10 days, is a more reliable diagnostic sign

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Treatment
organized hygienic conditions, nursing care of the patient and protection from

secondary infections
hospitalized when they are severe and complicated; home conditions are unsatisfactory, or it is impossible to arrange due nursing care; when epidemiological signs are present
fresh and clean air is very important for the patient
diet should be nourishing, easily digestible, and have a minimum of solid particles; liquids and soups should be preferre

Слайд 21

Treatment
hospitalized when they are severe and complicated;
home conditions are unsatisfactory,

or it is impossible to arrange due nursing care;
when epidemiological signs are present
antibiotics are given in case of complications, which are usually of bacterial nature

Слайд 22

Prophylaxis
Carantin is during 21 days after contact
Gamma-globulin is only used for

prophylactic purposes in a small number of children who were in contact with the measles patients and are 3-months to one year of age dose of 1.5 ml
Patient should be isolated until the 5th day from the outbreak of eruption
Vaccine strategy is to immunize all infants at 12 to 15 months of age with measles-mumps-rubella (MMR) vaccine

Слайд 23

Rubella
The agent that causes rubella is a microvirus, it contains a

single-stranded RNA, and is sensitive to chemical agents and heat

Слайд 24

Epidemiology
The source of infection is a sick person, who probably becomes

infective a few days before the disease becomes manifest
Contagiousness does not probably disappear two weeks (and over) after the rash resolves
The aerial-droplet route transmits the infection
Pregnant women with manifest or symptomless rubella may become the source of intrauterine infection of the fetus
Susceptibility to rubella is high
Life-long stable immunity develops as a rule

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Clinical Manifestations
incubation period lasts 15-21 days, sometimes up to 24 days
slight

rise in temperature is noted
occasionally slight malaise, cough, and reddening of the conjunctiva (conjunctivitis)
the typical symptom is swelling of the post-auricular cervical, sub-occipital, and other lymph nodes, which develops 1-3 days before the eruption and disappears several days after it subsides

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Rash
the rash invades the face and neck, and covers the

whole body within a few hours
localized mainly on the extensor surface of the limbs
elements are pale red, round or oval spots, with no tendency to coalesce
rash lasts 2 or 3 days and disappears rapidly without leaving any pigmentation and desquamation

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Blood counts demonstrate leukopenia, lympho, and numerous plasma cells (10-15 %)
Complications

are exceptionally rare :
arthropathy,
otitis,
pneumonia,
nephritis, polyneuritis
encephalitis and encephalomyelitis cases have been reported

Слайд 28

Clinical manifestations of congenital rubella:
“Сongenital rubella syndrome" are :
cataract,
cardiac defects,

deafness

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Congenital rubella
microcephalic hydrocephalus, deafness, cataract, retinopathy, microphthalmia, glaucoma, cardiac defects
A risk

of various embryopathies arises in women with rubella:
cataracts in the 5th-6th week,
deafness in the 9th week,
and cardiopathy in the 5th-10th week

Слайд 30

no treatment is required
patient should be isolated until the 5th day

from the outbreak of eruption
current vaccine strategy is to immunize all infants at 12 to 15 months of age with measles-mumps-rubella (MMR) vaccine and to administer a second dose of MMR during childhood

Treatment

Prophylaxis

Слайд 31

Scarlet Fever
Scarlet fever is an acute infectious disease, characterized by lesions

of oropharynx with submaxillary lymphadenitis, fever toxemia, rash and then desquamation

Слайд 32

pathogen of scarlet fever is a β-hemolytic
Streptococcus group A
have

considerable stability to the influence of physical factors
streptococcus produces exotoxins (Erythrogenous exotoxin )
stable antitoxic immunity is acquired against erythrogenous toxin
bacterial antigens of streptococcus and antibodies against them are typospecific and antibacterial immunity is not stable

Etiology

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Epidemiology
Scarlet fever is anthroponozic
The source of infection is a child with

scarlet fever or with other forms of streptococcal infection (tonsillitis, nasopharyngitis).
Duration of infectious period may fluctuate from some days to several weeks or sometimes months
The principal route of scarlet fever infection is an air-droplet one. Alimentary route plays insignificant
The contagious index is about 40 %.

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Pathogenesis
The principal portal of entry in scarlet fever is mucous membrane

of oropharynx
The infection may penetrate through damaged skin (in bums or injuries) or mucous membranes of the genitals (extrabuccal scarlet fever)
complex pathologic process, which may be presented in the form of three lines of pathogenesis: toxic, septic and allergic ones

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The toxic syndrome is the result of influence of the toxic

substances produced by the hemolytic streptococcus
the signs of toxemia in the form of fever,
rash,
headache, and vomiting,
lesions of the vegetative nervous system

The septic syndrome includes primary inflammation in the portal of entry and microbial streptococcal complications
purulent one and spreading of hemolytic streptococcus from the primary focus to the surrounding tissue and through lymphatic and blood vessels

Слайд 36

The allergic syndrome
is caused by the sensitizing substances of hemolytic

streptococcus, which are proteins
reaches its peak on the 2nd -3rd week of illness
allergic syndrome is manifested by various eruptions on the skin, myocarditis, glomerulonephritis, synovitis and "Allergic waves”

Слайд 37

Clinical Manifestations
The incubation period for scarlet fever is 2 to 7

days
The disease is started in fever, vomiting, sore throat and toxic symptoms such as headache and malaise

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Tonsillitis
Scarlatinal tonsillitis may be catarrhal, follicular or necrotic
Tonsillitis is accompanied by

regional lymphadenitis
The upper border of hyperemia is on the anterior palatal arches and on the base of the uvula (delimited hyperemia)

is a typical sign of scarlet fever

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Tongue
During the first 1 or 2
days the dorsum has

a
white "fur coat",
and the tip and edges
are reddened
By the fourth or fifth
day the white coat has peeled off
The red, glistening tongue, studded with prominent papillae, presents the appearance of raspberry ("raspberry tongue')

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Exanthema
It becomes generalized very rapidly.
Patient face is
typical in scarlet
fever

- cheeks are
red, smooth and
flushed, and the
area around the
mouth is pale,
lips are crimson.

Слайд 41

Rash is more intense in skin folds such as the axillae,

cubital, inguinal, popliteal, and also on skin of the neck, breast, abdomen, buttocks.

Слайд 42

Tiny petechiae occur in the creases of the folds of the

joints and form transverse lines (Pastia's sign) that persist after the rash has faded.
Rash usually remains for 4-5 days

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initially on the face on the second week as fine branny

flakes
desquamation skin of the trunk comes off in larger, thicker flakes
sometimes a retrospective diagnosis

Desquamation

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Cardiovascular changes
In acute period of scarlet fever tachycardia, increased blood

pressure
Bradycardia, arrhythmia, decreasing of blood pressure, dull heart sounds, systolic murmur occur the 4th-5th day of illness
N. F. Filatov has described the so-called “scarlatinal heart”
The bases of these changes are extracardiac disorders of vegetative nervous system
There is leukocytosis, neutrophilia, increased ESR in the acute period of scarlet fever

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Classification
Typical: mild, moderate, severe
Atypical (extrabuccal forms) - they are characterized by

a short-term incubation period, absence of mild tonsillitis, rash appears near the portal of entry, it is more intensive there: burn, injury, puerperal
The forms with aggravated signs are atypical too; they are hypertoxic and septic ones

Слайд 46

Complications
early one (first week) - septic complications are tonsillitis, lymphadenitis, otitis

media
allergic ones the late one (2nd-3rd week) - allergic complications include lesions of kidneys (nephritis), heart (myocarditis) and joints (synovitis)

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Treatment
Hospitalization takes
Severe course of scarlet fever with various complications.
Children

from boarding schools and other institutions

Antibiotics should be administered
Penicillin should be given in the dosage of 100 000/kg/ day for 7-10 days

The diseases with the exanthemas syndromes

Содержание

Measles (Morbilli) The pathogenic agent causing measles is the paramyxoviruses. The

EpidemiologyThe source of infection - a sick personInfectivity is greatest in

The virus is expelled from the organism in the secretion of

PathogenesisThe portal of entry is the mucous membrane of the respiratory

The process in the bronchitis and bronchiolitis has a tendency to

Clinical manifestationsThe period of measles- incubation period– catarrhal period– eruptive period– period of pigmentationThe incubation

Catarrhal period a rise in temperature, headache, rhinitis, and coughgeneral malaise,

Belsky-Filatov-Koplik's spots on the buccal mucosa on the line of opposition

The eruptive period stage begins with a new rise of temperaturefirst

Elements of the rash look like pink papules of a soft

Period of pigmentation subsiding rash becomes less prominent and assumes a

Blood at the end of the incubation period, the blood picture

ClassificationTypical form:– mild– moderately severe-- severe. Atypical forms:– measles with a toxic– abortive– rudimentary course-- mitigated

Mitigated form is in children who underwent serum prophylactic immunizationthe incubation

ComplicationsLaryngitis - of measles croup Pneumonia is one of the most

Nervous complications are serous meningitis, encephalitis

DiagnosisMeasles must be identified as early as possible. The diagnosis is

Specific diagnosisThe diagnosis is verified by a serological test - hemagglutina-don-inhibition

Treatmentorganized hygienic conditions, nursing care of the patient and protection from

Treatmenthospitalized when they are severe and complicated; home conditions are unsatisfactory,

ProphylaxisCarantin is during 21 days after contactGamma-globulin is only used for

RubellaThe agent that causes rubella is a microvirus, it contains a

EpidemiologyThe source of infection is a sick person, who probably becomes

Clinical Manifestationsincubation period lasts 15-21 days, sometimes up to 24 daysslight

Rash the rash invades the face and neck, and covers the

Blood counts demonstrate leukopenia, lympho, and numerous plasma cells (10-15 %)Complications

Clinical manifestations of congenital rubella:“Сongenital rubella syndrome" are :cataract, cardiac defects,

Congenital rubellamicrocephalic hydrocephalus, deafness, cataract, retinopathy, microphthalmia, glaucoma, cardiac defectsA risk

no treatment is requiredpatient should be isolated until the 5th day

Scarlet FeverScarlet fever is an acute infectious disease, characterized by lesions

pathogen of scarlet fever is a β-hemolytic Streptococcus group Ahave

EpidemiologyScarlet fever is anthroponozicThe source of infection is a child with

PathogenesisThe principal portal of entry in scarlet fever is mucous membrane