Indiana University Infectious Diseases Fellowship
3 Mar,
7 tweets, 4 min read
#idboardreview 40 F returned from Europe 2 wks ago, has been tired, now w/ F & rash on face quickly spread to trunk & legs involves palms & soles. Pharyngeal erythema, leukopenia, thrombocytopenia, mild transaminitis. Diagnosis? #medEd #idmedEd #IDtwitter 
#measles negative-stranded RNA virus that belongs to the genus ‘Morbillivirus’, hence the term morbilliform rash
From Jan-Se2019 >1,200 cases of #measles greatest # of cases in 🇺🇸 since 1992. occurs primarily among unvaccinated children/young adults. Spread via droplet nuclei when an infected person coughs or sneezes. most contagious vaccine-preventable dz w/ 2ndry attack rate 90%
#measles Incubation period is 7-21 days. Patient is infectious from 4 days before until 4 days after onset of rash. spreads first to local lymphoid tissue & then disseminated throughout blood stream through infected lymphocytes, infecting cells in almost all organ systems
#measles prodrome of fever, malaise, Koplik’s spots, 3 C cough, coryza conjunctivitis ➡️maculopapular rash w/ cephalocaudal & centrifugal spread. Complications (laryngitis, otitis media, pneumonia, diarrhea) ~30%. Subacute sclerosing pan-encephalitis rare but potentially fatal
#measles On initial suspicion: 😷 & negative pressure room. Dx IgM serology or nasopharyngeal/throat swab PCR. Treatment usually supportive; typically improve <48 hours after rash onset. Airborne isolation is recommended for at least 4 days after rash onset
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