Emergency Medicine Board Bombs 253. Measles in the ER: one clue you can't ignore!
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Mar 16, 2025 Measles is making a comeback, and recognizing its symptoms is crucial. Learn about the key distinctions to accurately diagnose it, including the infamous 'three C's' and identifying the rash. The discussion also delves into complications like encephalitis and the vital role of vitamin A in treatment. From differentiating measles from other viral infections to the significance of public health precautions, this episode is packed with insights for emergency medicine professionals.
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Key Measles Indicators
- Measles presents with a rash starting at the hairline and spreading downwards, preceded by cough, runny nose, and conjunctivitis (the three Cs).
- Koplik spots (small white spots on the buccal mucosa) are pathognomonic for measles, distinguishing it from other viral exanthems.
Differentiating Measles
- Rubella (German measles) has milder symptoms than measles, with a faster-fading rash and no Koplik spots.
- Roseola's rash starts centrally on the trunk and spreads outwards, differentiating it from measles.
Fifth Disease Characteristics
- Erythema infectiosum (fifth disease) is characterized by the "slapped cheek" rash in children.
- In adults, fifth disease can manifest with arthritis or polyarthralgias and a lacy, reticular rash on the extremities.