Visual Diagnosis Vol 3.1

Visual Diagnosis

Case 3.1

A 7-year-old boy is brought to the ED by his mother after she noticed the rash below on his body.  The mom states that the rash first appeared on her son’s face  and then rapidly spread to his neck, back, chest, and legs.  Mom states that her son complained of a sore throat for the last couple of days and he had a low-grade fever.  Mom states that her son is vaccinated with all vaccines except those that have live viruses.  On exam, you note postauricular and posterior lymphadenopathy.  The rash is pink to red and maculopapular.

rash1

1. What is the diagnosis?

2. What vaccine could have prevented this condition?

3. What is the most concerning complication of this condition?

Please post your answer in the “reply box” or click on the “comments” link  You will not see your answer post until next week when all of the submitted answers will be posted.  Good luck!

VizD is a weekly contest of an interesting or pathognomonic image from emergency medicine. Its goal is to integrate learning into a fun and relaxed environment. All images are original and are posted with the consent of the patient.

12 Responses

  1. 1. Measles/Rubella (German Measles)

    2. MMR

    3. Encephalitis/SSPE

  2. 1.) Measles
    2.) MMR
    3.) encephalitis (subacute sclerosing panencephalitis)

  3. 1. Rubella
    2. MMR
    3. encephalitis

  4. The child has rubella, aka german measles, and this could have been prevented with the MMR vaccine. The most serious complication of this condition is not a concern for this patient because he is both too young and too male to be pregnant. The complication is congenital rubella syndrome. Also, it helps to confirm the diagnosis when the first picture to show up in google images when rubella is seached is the exact picture in question 🙂

  5. 1. Rubella
    2. MMR
    3. mild, self limiting usually if postnatal, usually arthralgias

    most feared is infection of mother to
    fetus in first trimester leading to congenital rubella syndrome causing spontaneous abortion 20%,
    if the baby survives most common cardiac manifestation is PDA, multiple organ system failure

  6. 1. Measles
    2. MMR
    3. Pneumonia is a common complication. May also cause encephalitis.

  7. Rubella / German Measles

    MMR

    Encephalitis

  8. 1. Rubella “German Measles”
    2. MMR vaccine would have prevented this
    3. Of concern is that this child’s respiratory secretions can transmit the rubella virus and if a pregnant women in her 1st trimester comes in contact with this child she may put her fetus at risk of congenital rubella syndrome; cataracts, CNS defects like MR and deafness, hepatitis and heart disease.

  9. Measles
    MMR
    Encephalitis and/or corneal involvement

  10. Ansurs!

    1. Rubella would be my guess because of the vaccine clue, but the picture looks like scarlet fever too.
    2. MMR
    3. there are teratogenic effects if a fetus contracts rubella.

  11. Measles
    MMR could have prevented
    Encephalitis is the most fatal/serious complication but it is rare.

  12. 1) Measles
    2) MMR
    3) Encephalitis

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