Koplik’s spots occur in which phase of measles –
Correct Answer: End of prodromal phase
Description: Ans. is 'a' i.e., End of prodromal phase Clinical manifestations of measles* Clinical features are divided into following stages :-1) Prodromal stage# It begins 10 days after the infection and is characterized by fever, coryza with sneezing, lacrimation and photophobia. A day or two before eruptive phase (appearance of rash), Koplik spot (pathognomonic of measles) appears on buccal mucosa, opposite the 1st and 2nd lower molars.2) Eruptive phase# It begins 14 days after infection. A maculopapular rash begins behind the earsand spreads rapidly.3) Post measle stage# It is characterized by weight loss, growth retardation, diarrhea, cancrum oris, candidiasis, reactivation of TB and malnutrition particularly vitamin A deficiency (keratomalacia, xerophthalmia).* Complications of measles arei) Respiratory: Otitis media (most common complication), pneumonia (Giant cell or Hecht's pneumonia), bronchitis, laryngitis, croup.ii) CNS: These are most serious and include encephalitis, transverse myelitis and a rare complication SSPE (Subacute sclerosing panencephalitis).iii) Gastrointestinal: Gastroentritis, hepatitis, appendicitis, diarrhea, ileocolitis, mesenteric adenitis.iv) Others: Myocarditis, glomerulonephritis, thrombocytopenia.* Measles-associated mortality is usually higher among the very young and very old. Mortality in developing countries may be as high as 10 to 15% due to one or several factors, including the early age of infection, malnutrition, diarrhea, concomitant/secondary bacterial infections, and lack of access to good medical care. Most common cause of death is pneumonia in children and encephalitis in adults. Mortality rate in measles encephalitis is 15-20%.
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