Koplik spots are seen in
Correct Answer: Measles
Description: Ans. a (Measles). (Ref. Harrison, Medicine, 18th/Table 17-1; Figure e7-2)Koplik's spots, which manifest as white or bluish lesions with an erythematous halo on buccal mucosa, usually occur in the first 2 days of measles and may briefly overlap the measles exanthem. Presence of the erythematous halo differentiates Koplik's spots from Fordyce's spots (ectopic sebaceous glands), which occur in the mouths of healthy individuals.MEASLES (rubeola)# It is caused by a paramyxovirus, which is spread by respiratory droplets produced by sneezing or coughing.# Most infectious of all microbial agents.# Maternal antibodies protect for 6 months.# The measles incubation period is 8-15 days.# Classically, measles is preceded by the three C's:- Hacking cough,- Coryza (nasal rhinorrhea and congestion), and- Conjunctivitis, plus photophobia, malaise, and a high fever persisting for several days.# Part of the enanthem is called Koplik's spots which appear on or after the second day of fever.- Prodromal illness, 1-3 days heralds catarrhal stage.- Catarrhal stage is characterized by respiratory symptoms and Koplik spots.# Koplik spots (pathognomonic of measles) are seen on buccal mucosa opposite to 2nd upper molar tooth.# Koplik's spots develop on the buccal mucosa 2 days before the rash appears. The characteristic rash of measles begins 2 weeks after infection, when the clinical manifestations are most severe, and signal the host's immune response to the replicating virus.# The exanthem classically appears on the fourth day of fever. Rash is "morbilliform" (means measles-like).# RASH appears as natural antibody develops, lasts 5-6 days and then gradually fades with pigmentation.# Generalized lymphadenopathy, diarrhea, convulsions and bacterial/Hoest pneumonia can occur.# SSPE is a rare and late complication, after 6-7 years.# Edmonsten Zagreb strain is used in vaccine preparation. The current monovalent attenuated live virus vaccine (Attenuvax) contains the Moraten ("more attenuated") strain of measles virus, which effectively confers immunity while reducing the incidence of adverse events following vaccination.Diseases Associated with Fever and RashDiseaseEtiologyDescriptionClinical SyndromeRubeola (measles, first disease)Paramyx ovirusDiscrete lesions that become confluent as rash spreads from hairline downward, sparing palms and soles; lasts 3 days; Koplik's spotsCough, conjunctivitis, coryza, severe prostrationRubella (German measles, third disease)TogavirusSpreads from hairline downward, clearing as it spreads; Forscheimer spotsAdenopathy, arthritisErythema infectiosum (fifth disease)Human parvovirus B19Most common among children 3-12 y old;Bright-red "slapped-cheeks" appearance followed by lacy reticular rash that waxes and wanes over 3 weeks; rarely, papular-purpuric "gloves-and-socks" synd on hands and feet.Mild fever; arthritis in adults; rash following resolution of feverDiseaseEtiologyDescriptionClinical SyndromeExanthem subitum (roseola, sixth disease)Human herpesvirus 6Usually affects children <3 years old; Diffuse maculopapular eruption over trunk and neck; resolves within 2 daysRash following resolution of fever; similar to Boston exanthem (echovirus 16); febrile seizures
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