Measles physical examination: Difference between revisions
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{{Measles}} | {{Measles}} | ||
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==Overview== | |||
Measles is a condition, that is best diagnosed clinically based on a constellation of signs and symptoms. [[Fever]], [[rash]] and [[conjunctivitis]] are 3 major physical findings that must be looked out for, while making the diagnosis of [[measles]].<ref name="CDC"> {{ cite web| title= CDC Measles | url=http://www.cdc.gov/measles/hcp/index.html}} </ref><ref name="WHO"> {{ cite web| title=WHO GUIDELINES FOR EPIDEMIC PREPAREDNESS AND RESPONSE TO MEASLES OUTBREAKS | url=http://www.who.int/csr/resources/publications/measles/WHO_CDS_CSR_ISR_99_1/en/}} </ref> | |||
==Physical Examination== | |||
===Vitals=== | |||
====Temperature==== | |||
* A high [[fever]] is always present, it could be as high as 105°F. | |||
====Pulse==== | |||
* [[Tachycardia]] may be present, specially with the onset of [[fever]]. | |||
====Respiratory Rate==== | |||
* [[Tachypnea]] may be present, specially in patients complicated with [[pneumonia]]. | |||
===Skin=== | |||
====Rash==== | |||
* Three to five days after the start of symptoms, a red or reddish-brown '''itchy''' [[rash]] appears. | |||
* The rash usually begins on a person’s face at the hairline and spreads downward to the [[neck]], [[trunk]], [[arms]], [[legs]], and [[feet]]. | |||
* It also regresses in the same manner as it appeared in about 5-7 days. | |||
* The rash is blanching, maculopapular in nature to begin with but may coalesce later to become [[plaque]]s and [[patch]]es. | |||
* When the [[rash]] appears, a person’s [[fever]] may spike to more than 104°F. | |||
* Shown below are images depicting the characteristic [[rash]] of [[measles]]. | |||
<small>Images obtained from the Public Health Image Library</small><ref name="PHIL">{{ cite web| title= Public Health Image Library (PHIL) | url=http://phil.cdc.gov/phil/home.asp}} </ref> | |||
<gallery>Image:Day3measlesrash.jpg|Image showing measles rash on day 3. | |||
Image:Day4measlesrash.jpg|Image showing characteristic day 4 appearance of measles [[rash]]. | |||
Image:Measlesrashday3.jpg|Typical appearance of rash on day 3, measles. | |||
Image:Measles 1.jpg| Face of child with measles. | |||
Image:Measles 3.jpg| Characteristic red blotchy pattern on his buttocks during 3rd day of the rash. </gallery> | |||
===Eyes=== | |||
====Conjunctivitis==== | |||
* Conjuntivitis, also known as [[pink eye]], is one of the 3 'C' 's in the classical 3 'C' presentation of measles (other 2 being [[cough]] and [[coryza]]). | |||
* Shown below is an image illustrating pink eye in a child with measles: | |||
<small>Images obtained from the Public Health Image Library</small><ref name="PHIL">{{ cite web|title=Public Health Image Library (PHIL) | url=http://phil.cdc.gov/phil/home.asp}} </ref> | |||
<gallery>Image:Eyesinmeasles.jpg|Conjunctivitis (pink eye) in a child with measles</gallery> | |||
===Throat=== | |||
====Koplik's spots==== | |||
* Koplik's spots are tiny white spots with erythematous base and bluish-white centers found inside the mouth at the base of second molars. | |||
* These appear usually 2-3 days after initial prodrome and may or may not persist until the rash disappears. | |||
* Although they are pathognomic, Koplik's spots are not present in all the cases. | |||
* Its absence does not exclude the diagnosis of [[measles]]. <br> | |||
<small>Images obtained from the Public Health Image Library</small><ref name="PHIL">{{ cite web| title= Public Health Image Library (PHIL) | url=http://phil.cdc.gov/phil/home.asp}} </ref> | |||
<gallery>Image:Koplikspot1.jpg|Image showing bluish-grey spots on an erythematous base known as Koplik's spots | |||
Image:Koplikspot2.jpg|Image showing Koplik's spots opposite the base of second molars.</gallery> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WikiDoc Help Menu}} | {{WikiDoc Help Menu}} | ||
{{WikiDoc Sources}} | {{WikiDoc Sources}} | ||
[[Category:Pediatrics]] | |||
[[Category:Dermatology]] | |||
[[Category:Viral diseases]] | |||
[[Category:Mononegavirales]] | |||
[[Category:Ophthalmology]] | |||
[[Category:Otolaryngology]] | |||
[[Category:Pulmonology]] | |||
[[Category:Disease]] |
Latest revision as of 22:40, 29 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Vidit Bhargava, M.B.B.S [2]
Overview
Measles is a condition, that is best diagnosed clinically based on a constellation of signs and symptoms. Fever, rash and conjunctivitis are 3 major physical findings that must be looked out for, while making the diagnosis of measles.[1][2]
Physical Examination
Vitals
Temperature
- A high fever is always present, it could be as high as 105°F.
Pulse
- Tachycardia may be present, specially with the onset of fever.
Respiratory Rate
Skin
Rash
- Three to five days after the start of symptoms, a red or reddish-brown itchy rash appears.
- The rash usually begins on a person’s face at the hairline and spreads downward to the neck, trunk, arms, legs, and feet.
- It also regresses in the same manner as it appeared in about 5-7 days.
- The rash is blanching, maculopapular in nature to begin with but may coalesce later to become plaques and patches.
- When the rash appears, a person’s fever may spike to more than 104°F.
- Shown below are images depicting the characteristic rash of measles.
Images obtained from the Public Health Image Library[3]
-
Image showing measles rash on day 3.
-
Image showing characteristic day 4 appearance of measles rash.
-
Typical appearance of rash on day 3, measles.
-
Face of child with measles.
-
Characteristic red blotchy pattern on his buttocks during 3rd day of the rash.
Eyes
Conjunctivitis
- Conjuntivitis, also known as pink eye, is one of the 3 'C' 's in the classical 3 'C' presentation of measles (other 2 being cough and coryza).
- Shown below is an image illustrating pink eye in a child with measles:
Images obtained from the Public Health Image Library[3]
-
Conjunctivitis (pink eye) in a child with measles
Throat
Koplik's spots
- Koplik's spots are tiny white spots with erythematous base and bluish-white centers found inside the mouth at the base of second molars.
- These appear usually 2-3 days after initial prodrome and may or may not persist until the rash disappears.
- Although they are pathognomic, Koplik's spots are not present in all the cases.
- Its absence does not exclude the diagnosis of measles.
Images obtained from the Public Health Image Library[3]
-
Image showing bluish-grey spots on an erythematous base known as Koplik's spots
-
Image showing Koplik's spots opposite the base of second molars.