Question of the Week

Question :

Posted On : 24 May 2007

How to differentiate scarlet fever from atypical measles [measles in immunised childeren]?

Expert Answer :

No expert answer available.

Answer Discussion :

AZHAR

rash

17 years ago

puru

clinically
running nose and cough are hall marks of measles { how ever modified by immunity }
what is modified is duration of fever ,sickness, skin rashes .
Distribution of rashes in scarlet fever may help .
oral cavity apearance toungue more involved in scarlet fever .in measles more of mucosa involved . pharyngeal involvement especially exudative suggests scarlet fever.
some tender lymph nodes if present may help for scarlet fever
of course simple blood investigation
TC ,DC ESR and peripheral smear is enough to rule out viral and support bacterial { measles unless with bronho pneumonia the picture suggests viral .secondary infection in measles happens after at least 5 days . so in the initial days of rash viral picture definitly goes for measles
puru

17 years ago

pramod m.kulkarni

strawberry tongue,palpable-gooseskin-sandpaper rash,absence of conjunctivitis,prom.tonsillar inflm,prominent lymphadenopathy,low grade-absent resp.complaints and signs
neutrophilia,leukocytosis,positive crp
are significant pointers of scarlet fever.....

17 years ago

pediatriconcall

Atypical measles occurs in individuals who were previously immunized with the killed measles vaccine between 1963 and 1967 and who have incomplete immunity. When they are exposed to the measles virus, a mild or nonexistent prodrome of fever, headache, abdominal pain, and myalgias precedes a rash that begins on the hands and feet and spreads centrally. The rash is most prominent in the body creases and may be macular, hemorrhagic vesicles, petechial, or urticarial.

All persons vaccinated after 1967 received the live attenuated measles vaccine, which is not associated with atypical measles.

Scarlet fever is is characterized by prodrome of Sore throat, Headache, vomiting, Abdominal pain and Fever followed by appearance of rash 1-2 days after onset of illness, first on the neck and then extending to the trunk and extremities. The exanthem is usually of coarse and the erythema blanches with pressure. A few days following generalization of the rash, it becomes more intense along skin folds and produces lines of confluent petechiae known as the Pastia sign. These lines are caused by increased capillary fragility. The rash begins to fade 3-4 days after onset, and the desquamation phase begins. This phase begins with flakes peeling from the face. Peeling from the palms and around the fingers occurs about a week later and can last up to a month. Daignosis of scarlet fever can be established by throat culture for streptococcus and ASLO test.

17 years ago

JAIME BIMSTEIN

PASTIA SIGN, POSTDESQUAMATION STATE AND NON CONJUNTIVAL INVOLVEMENT IN SCARLET FEVER. YOU DON'T HAVE THEM IN MEASLES

17 years ago

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