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Micro - MMR (i) (Measles (symptoms (maculopapular rash (appears 2-4 days…

- - - - appears 2-4 days after prodrome (early non-specific symptoms)
      - becomes confluent
      - begins @ hairline + spreads down (fades in this way too)
      - blanches initially, but non-blanching after 3-4 days
      - persists for 5-6 days
      - discs that are raised in centre
      - non-painful
      - skin feels rough (hair follicles extended))
    - - minute blue/white spots on an erythematous base on buccal mucosa
      - resembles salt/sugar
      - PATHOGNOMONIC - only in measles
  - - - SSPE - subacute sclerosing panencephalitis
        
        rare chronic progressive brain inflamm
        
        degenerative
        
        thought to be caused by persistent measles infection in brain
        
        average onset = 7 yrs later (range = 1 month-27 yrs)
        
        insidious onset
        
        dormant @ first
        
        then progressive deterioration in behaviour + intellect
        
        followed by ataxia, myoclonic seizures + ultimately death
        
        Dx: IgM detection in CSF
      - encephalitis
        
        esp adults
        
        appears a few days after rash onset
        
        1 in 1000
        
        15% fatal
        
        25% survive but with neurological sequelae
      - Acute disseminated encephalomyelitis (ADEM)
        
        presents during recovery phase, within 2 wks of exanthem (widespread rash)
        
        1 in 1000
        
        probably post-infectious immune response
        
        10-20% mortality
  - - - retinitis -> corneal ulceration + scarring
      - can be permanent
  - - - serology (4-fold IgM increase - can also be done on blood)
      - PCR