Measles and Scarlet Fever Kawasaki Disease: Fatin & Eileen
Measles and Scarlet Fever Kawasaki Disease: Fatin & Eileen
KAWASAKI DISEASE
MEASLES Measles is a highly contagious,
serious disease caused by a
virus. (in the paramyxovirus
family)
Currently rare after
introduction of MMR vaccine
HOW IT IS SPREAD?It is normally passed through direct
contact and through the air.
Measles is so contagious that if one
person has it, up to 90% of the people
close to that person who are not immune
will also become infected.
Measles virus can live for up to two
hours in an airspace after an infected
person leaves an area.
KOPLIK
SPOTS
- WHITE SPOT
USUALLY
FOUND ON
BUCCAL
MUCOSA
-
PATHOGNOMONI
C BUT
DIFFICULT TO
SEE
Rash
Discrete maculopapular rash
Initially become blotchy and
confluent
It spreads downward from
behind of the ears to the face
and neck and spread to the
whole of the body
May desquamate in the second
week
TREATMENT OF MEASLES
No specific antiviral treatment for measles virus.
Severe complications from measles can be reduced through supportive care.
that ensures good nutrition, adequate fluid intake and treatment of dehydration
Antibiotics should be prescribed to treat eye and ear infections, and pneumonia.
Vitamin A supplements can be given in 2 doses 24 hours apart. This treatment
restores low vitamin A levels during measles that occur even in well-nourished
children and can help prevent eye damage and blindness.
COMPLICATIONS OF MEASLES
Complications are more likely in children with a poor immune system, those who
are malnourished or children age under 5 years old.
Common complications
Ear infections occur in about one out of every 10 children with measles.
Diarrhea is reported in less than one out of 10 people with measles.
Severe complications
Pneumonia : 1 out of every 20 children, the most common cause of death from measles in young
children
Encephalitis : 1 out of every 1000 children, can lead to convulsion and can leave the child deaf or
mentally retarded.
Long-term Complications
Subacute sclerosing panencephalitis (SSPE) is a very rare, but fatal
disease of the central nervous system that results from a measles virus
infection acquired earlier in life.
SSPE generally develops 7 to 10 years after a person has measles, even
though the person seems to have fully recovered from the illness.
Since measles was eliminated in 2000, SSPE is rarely reported.
SCARLET Scarlet fever (sometimes called scarlatina)
is an infectious disease caused by bacteria
FEVER called Streptococcus pyogenes, or group
A streptococcus (GAS)
Young infants
-more sevely affected
-Have incomplete sx
ETIOLOGY
Remains unknown
Possible bacterial toxin or viral agents with genetic predisposition
DIAGNOSTIC CRITERIA :
#WARMCREAM
Warm : fever >5day
R
M
E
INCOMPLETE KAWASAKI
DISEASE
Tend to occur in young infant
Have incomplete symptoms in which not fulfill diagnostic criteria
Must be high suspicious-can develop coronary artery dilatation or
aneurysm
INVESTIGATION
No diagnostic test
FULL BLOOD COUNT NORMOCYTIC ANEMIA
LEUCOCYTOSIS
THROMBOCYTOSIS
- AFTER 10TH DAY OF ILLNESS
- LAST FOR FEW WEEKS
LIVER FUNCTION TEST ELEVATED ALANINE
TRANSAMINASE
HYPOALBUMINEMIA
(ALBUMIN <3G/DL)
ACUTE PHASE REACTANTS ESR HIGH
CRP HIGH
URINE >10 WBC/HPF
ECHOCARDIOGRAPHY TO LOOK FOR/MONITOR
CORONARY ARTERY
ANEURYSM DEVELOPMENT
INDICATION OF ECHO
Prolong fever
With other 2 criteria
Periungual desquamation
2 criteria + thrombosis
Rash without any other explaination
MANAGEMENT
Primary Tx
1. IV Immunoglobulin 2gm/kg infusion over 10-12h
- If start <10d of onsetprevent coronary vascular damage
2. Oral aspirin 30mg/kg/d (anti-inflammatory dose) for 2w or until afebrile for 2-3d
Maintainance
1. Oral Aspirin 3-5mg/kg/d (anti-platelet dose) for 6-8w or until ESR and platelet
normalize
2. If coronary artery aneurysm presentcont Aspirin until resolves
3. If develop giant coronary artery aneurysmlong term warfarin therapy