Koplik spots are seen in: March 2013
**Question:** Koplik spots are seen in: March 2013
**Core Concept:** Koplik spots are characteristic lesions observed in the oral mucosa during the early stage of infection with the Epstein-Barr virus (EBV), which is the causative agent of infectious mononucleosis (glandular fever). These spots are designated after Dr. Leopold Koplik, a Polish pediatrician who first described them in 1896.
**Why the Correct Answer is Right:** Koplik spots are seen during the primary infection with EBV, which presents with a viral prodrome (symptoms) followed by the appearance of these spots and a few days later, the patient develops fever, fatigue, and enlarged lymph nodes. The lesions consist of a white, greyish-blue, or greyish-white papules (small bumps) on a red background, appearing on the buccal mucosa (inner cheek). These spots are a result of EBV infection-induced damage to the oral epithelial cells, leading to the presence of white-colored inclusions (intracellular viral particles) within these cells.
**Why Each Wrong Option is Incorrect:**
A. This option is incorrect because Koplik spots are a characteristic finding in the early stage of EBV infection and not seen in other viral infections.
B. This option is incorrect as Koplik spots are not seen in the later stages of EBV infection or in other viral infections. The spot typically disappears within 2-3 days as the patient progresses to the fever and lymphadenopathy phase of the illness.
C. This option is incorrect as Koplik spots are not seen in bacterial infections or any other non-viral infections of the oral cavity. The spots are specific to EBV infection.
D. This option is incorrect as Koplik spots are seen in the early phase of EBV infection, not in March 2013. They do not persist beyond 2-3 days and are part of the initial presentation of the infection.
**Clinical Pearl:** The presence of Koplik spots in conjunction with the clinical picture of infectious mononucleosis is crucial for the diagnosis of the condition. The combination of fever, sore throat, lymphadenopathy (enlarged lymph nodes), and Koplik spots allows for the confident identification of EBV infection.