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| | Clinical Vignette A clinical vignette is a concise presentation of an interesting or challenging patient encounter that stimulated an interesting learning issue. |  | Senior Member | | Posts: 379 Thanks: 0
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Join Date: Dec 2005 | | | Confluent, fine, erythematous, macular rash in a 7 year old child -
06-01-2007, 08:12 PM
A 7 year old boy is brought to a physician because of a nearly confluent, fine, erythematous, macular rash that is most pronounced on his trunk. He has had a mild fever for 36 hours, but does not appear very sick, and is happily playing when the pediatrician enters the examining room. Physical examination demonstrates a reddened throat with tonsillar exudates, enlarged cervical nodes including the occipital node, and questionable splenomegaly. The mother says that the boy has not been coughing, and no Koplik spots are noted. Which of the following is the most likely diagnosis? A. Bullous pemphigoid
B. Dermatitis herpetiformis
C. Herpes simplex
D. Measles
E. Rubella
I Love Clinical Vignette a concise presentation of an interesting & challenging patient encounter that stimulates an inquisitive learning session. |  | Senior Member | | Posts: 195 Thanks: 0
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Join Date: Apr 2006 Location: china | | | Re: Confluent, fine, erythematous, macular rash in a 7 year old child -
06-01-2007, 10:08 PM
Hi Bro. It's nice to be back again , well i still have busy shedule till one month after that i will be online daily.
well most likely diagnosis is E. Rubela
see u later bye
and hero my rememberence to u also hai miss u guys, see ya... |  | Senior Member | | Posts: 132 Thanks: 0
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Join Date: Feb 2006 | | | Re: Confluent, fine, erythematous, macular rash in a 7 year old child -
04-03-2007, 08:14 AM
The correct answer is E. | | The Following User Says Thank You to dr_ravi For This Useful Post: | | | Senior Member | | Posts: 379 Thanks: 0
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Join Date: Dec 2005 | | | The correct answer is E -
04-03-2007, 08:29 AM
Thats right friends the correct answer is E. This presentation (fine, nonblotchy, truncal rash in a not-very-ill child) is characteristic of rubella, or German measles. IgM specific for rubella can often be detected in serum within 1-2 days of developing the rash. The principal significance of this disease is that it can cause a devastating congenital infection characterized by ocular problems (cataracts, retinopathy, microphthalmos, glaucoma), cardiovascular problems (patent ductus arteriosus, ventricular septal defect, pulmonary stenosis), deafness, thrombocytopenic purpura, hepatosplenomegaly, CNS problems, and bony lesions.
Bullous pemphigoid (choice A) produces large, tense blisters.
Dermatitis herpetiformis (choice B) causes recurrent crops of small vesicles or papules.
Herpes simplex (choice C) is characterized by crops of vesicles on oral or genital sites.
Measles (choice D) causes a blotchy, maculopapular erythematous rash that begins on the face and spreads downward. Patients with measles are usually much sicker than those with German measles, and Koplik spots maybe seen on the buccal mucosa.
I Love Clinical Vignette a concise presentation of an interesting & challenging patient encounter that stimulates an inquisitive learning session. | | The Following User Says Thank You to Oak For This Useful Post: | | | Senior Member | | Posts: 379 Thanks: 0
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Join Date: Dec 2005 | | | Re: Confluent, fine, erythematous, macular rash in a 7 year old child -
04-03-2007, 08:31 AM
Hey Bharat, Where are you man? and Where is Hero I don't see him often.. me too disappeared had some works anyway lets rock again 
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