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Published in Samar Razaq, Difficult Cases in Primary Care, 2021
Koplik’s spots are pathognomonic of measles. They may be difficult to spot, and disappear as the illness progresses. There have been recent outbreaks of measles due to a lack of uptake of the measles, mumps and rubella vaccine in the last decade, because of unfounded fears of its link with autism. The child is usually very unwell and irritable with a high-grade fever. There is a high complication rate and may involve the lungs, eyes, ears, central nervous system and gastrointestinal tract. Subacute sclerosing panencephalitis is a rare complication of measles in which the virus survives in the cerebrum, only to be reactivated years later. It presents with behavioural change and a drop in intellectual level. This then progresses to movement disorders and mental deterioration. Severe dementia, seizures and eventually coma may follow.
Infection and immunology
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
5.17. Comparing measles (morbilli) with German measles (rubella), it is a characteristic of the former thatthe incubation period is longer.the temperature period is longer.pre-exanthem symptoms are of longer duration.Kopliks spots appear.suboccipital glands are more prominent.
Diagnostic strategy
Published in Caroline J Rodgers, Richard Harrington, Helping Hands: An Introduction to Diagnostic Strategy and Clinical Reasoning, 2019
Caroline J Rodgers, Richard Harrington
Pathognomonic signs and symptoms are those which are specifically indicative of a particular condition. Care needs to be exercised here, and it is best to have an appreciation of the positive predictive value of signs and symptoms rather than relying on a list of those which are deemed pathognomonic. For example, Koplik’s spots (white lesions on the buccal mucosa) have long been described as pathognomonic of measles.8 However, Koplik’s spots have since been described in echovirus and parvovirus B19 illnesses.9 Zenner and Nacul’s study of measles cases in the UK found that if Koplik’s spots were used as a diagnostic tool, the positive predictive value for a confirmed diagnosis of measles across hospital and primary care settings was 80%.9 Hence Koplik’s spots are a highly predictive (but not pathognomonic) finding for measles, and the authors suggest that if they are present in a case of suspected measles, the case should be treated as ‘probable measles’.9
Measles 101
Published in Postgraduate Medicine, 2019
Pavani Nathala, Safoora Fatima, Riley Sumner, Steven Lippmann
The prodromal phase appears approximately 10–12 days after incubation [8]. Fever increases in step-wise fashion up to 104°F, or higher. The prodrome also includes cough, tracheobronchitis, conjunctivitis, rhinitis, and coryza [8,9]. Koplik spots occur and are a pathognomonic sign. They are a cluster of bluish-white areas on the buccal mucosa, at the second molar [10–12]. The whitish portion is likely due to the destruction of glandular epithelial cells and the bluish-red halo around it is caused by vasodilation near the duct of the submucosal gland. In some persons of darker skin color, Koplik spots often appear more as depigmented areas. As the rash on the skin progresses, Koplik spots disappear and buccal mucous membrane return to their baseline [10,11].
Can a Measles Epidemic Be Avoided in 2022?
Published in Comprehensive Child and Adolescent Nursing, 2022
As every children’s nurse remembers from their undergraduate education, measles is a highly infectious viral respiratory disease, classically accompanied in the early stages by the appearance of Koplik spots on the inside of the cheeks. These are small white spots named after Dr. Henry Koplik of New York, who first described them in 1896 (Jain & Rathee, 2021).