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PEDIATRICS

■ Immunize close contacts who are unvaccinated. (Note MMR vaccine is

contraindicated in patients who are pregnant or who have significant

immunosuppression. Patients who cannot receive MMR should receive

immunoglobulin.)

■ Report disease to state health authorities.

COMPLICATIONS

■ Acute purulent otitis media is the most common complication.

■ Pneumonia is most common reason for admission.

■ Encephalitis (1/1000 cases)

■ Death (2/1000 cases in United States)

■ Measles infection during pregnancy may cause spontaneous abortion.

RUBELLA(GERMANMEASLES)

■ Viral infection (RNA virus)

■ Immunity conferred by MMR vaccination

■ Transmitted by respiratory droplets

■ Typically mild illness, except for congenital infection, which can cause

major birth defects

SYMPTOMS/EXAM

■ Low-grade fever

■ Exanthem: Erythematous papular rash begins on face, spreads to trunk

(see Figure 5.9).

■ Tender lymphadenopathy is common and usually involves the postauricu-

lar, suboccipital, and posterior cervical chains.

DIAGNOSIS

■ Clinical diagnosis

■ Serum testing can confirm diagnosis.

FIGURE 5.8. Measles (rubeolla). (See also color insert.)

(Reproduced, with permission, Kane K S-M, Ryder JB, Jonson RA, et al. Color Atlas & Synopsis of

Pediatric Dermatology. New York: McGraw-Hill, 2002:585.)

Rubella (German measles):

Rash with tender postauricular

lymphadenopathy