Clinical Question-5


What is the diagnosis ?


History


7 year male child presented to emergency department with history of fever for 3 days high grade fever with cough and runny nose.


On Examination


Tachycardia

Hemodynamically stable

Inflamed eyes

Rash over body

Rash started at the hairline after 2 days of fever and spread down the
body

It is also found that palms and soles are spared

No neurological symptoms


Oral mucous membrane IMAGE is given below.


Koplik spots, measles 6111 lores

What is the Clinical diagnosis?


A. Chickenpox

B. Measles

C. Rubella

D. Mumps



What is spot on mucous membrane in the Image?


Koplik spots, measles 6111 lores

A. Forschheimer spots

B. Koplik’s spots

C. Fordyce granules

D. Aphthous ulcers



In Measles which will be confirmatory for diagnosis of Mesales


A. IgM antibodies for Measles

B. IgG antibodies for Measles

C. Measles virus DNA from throat

D. IgE antibodies for Measles



When IgM antibodies for Measles comes as inconclusive which is the next test to be done?


A. Measles virus RNA from throat

B. IgG antibodies for Measles

C. Measles virus DNA from throat

D. IgE antibodies for Measles



Koplik spots appear in the mucosa is usually —– the onset of rash


A. 1 day before

B. 1 day after

C. 5 days before

D. 5 days after


Forschheimer spots

Koplik’s spots look like Forschheimer spots.

Forschheimer spots are a type of Exanthem that appears as discrete red spots over the soft palate as seen in Rubella


Koplik spots

Koplik spots are the peculiar spots present on the buccal mucosa and are considered a diagnostic/pathognomic feature of measles/rubeola in the pre-eruptive stage.


Fordyce’s spots


Fordyce’s spots – ectopic sebaceous glands

which have no erythematous halos and are found in the mouth of healthy individuals


Koplik spots
Differential diagnosis
1Fordyce granuleslack a bright red background
2Aphthous ulcerspainful and are less numerous
3Koplik spotsbluish-white spots, slightly raised with a diameter of approximately 2 to 3 mm on an erythematous base on the buccal mucosa opposite the first molar
4 Forschheimer spotsappears as discrete red spots over the soft palate as seen in Rubella
Koplik spots


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