QUIZ #1

A family who recently emigrated from Romania brings their 7-year-old child to the pediatrician with complaints of conjunctivitis and periorbital swelling. The child has had coughing with a runny nose and high fever for three days. Small lesions with blue-white centers are seen in his oral cavity. Which of the following is the most likely cause of this child’s symptoms?

(A) Diphtheria
(B) Pertussis
(C) Roseola
(D) Rubella
(E) Rubeola



answer
 The correct answer is E. Rubeola, also called measles, is a relatively rare illness in the
United States because of the ubiquity of the measles/mumps/rubella (MMR) vaccine. It presents with the prodrome described in this patient. The rash that spreads from head to toe over a three-day period develops one or two days after the appearance of Koplik’s spots, which are red oral lesions with blue-white centers.

Answer A is incorrect. Diphtheria is an illness virtually unknown in the United States because of the prevalence of the diphtheria/ tetanus/pertussis (DTaP) vaccine. It is caused 
by Corynebacterium diphtheriae and is characterized by a membranous pharyngitis.

Answer B is incorrect. Pertussis, or whooping cough, is also rare due to widespread vaccinations. It is a respiratory infection of children that characteristically produces coughing spasms followed by a loud inspiratory whoop.

Answer C is incorrect. Roseola is a febrile disease of very young children that begins with a high fever and progresses to a rash similar to measles. Infants and young children are most at risk. It is believed to be caused by human herpesvirus 6.

Answer D is incorrect. Rubella, also known as German measles, is a less severe viral exanthem. Many infections are subclinical, but rubella can cause severe birth defects when infection occurs during the prenatal period.

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