Rubella相关

Dr.Faust

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Genus: Rubivirus (if Rubivirus is mentioned, it always refers to Rubella virus)


could be subclinical in many cases


Adult infection:
Polyarthritis, arthropathy


Children infection:
Fever, postauricular adenopathy, lymphadenopathy, rash starts at head and moves down


Fetal infection:
before first 20 weeks of pregnancy (usually caused by contact in 1st trimester)
classic triad: PDA, cataracts and deafness ± "blueberry muffin" rash
with other fetures of premature delivery (LBW, neonatal thrombocytopenia and etc.)


Signs and symptoms
similar to flu, rashes may appear all over the body after 2 w of exposure and may last about 3 days


other symptoms include fever (usually below 38°C), lymphadenopathy (sub-occipital, postauricular, posterior cervical), joint pain and conjuctivitis
“风枕” 病毒


Complications
pneumonia (primary and secondary)
bronchitis
for severe cases:
encephalitis
thrombocytopenia
otitis


Forchheimer sign
Fleeting exanthem with small, red petechiae on soft palate (20% of all cases)
can also be detected in measles and scarlet fever.
bell of the palace


Diagnosis
IgM detection (1 year)


For PDA:
widening of pulse pressure with split S2
(due to increased amount of blood in pulmonary artery)


Prevention
vaccine
(live attenuated rubella vaccine)
(can induce both humoral and cell-mediated immunity)


Children are typically immunized against at age 12 months and age 4 years with the live measles, mumps, and rubella vaccine.
Any child below this range with age-appropriate vaccinations would not include protection against rubella.


Treatment
supportive and symptom-based treatment, no specific treatment
corrections of anomaly
special education for CRS


Prognosis
simple infection: great
CRS:  poor

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AKA German measles; 3-day measles;
Childhood exanthem (rash)
Acquired by inhalation of respiratory droplets


Mild fever, lymphadenopathy
Maculopapular rash (1-5 days after fever)
Characteristic lymphadenopathy
Posterior cervical
Posterior auricular


No specific treatment
Vaccine: Live attenuated virus (MMR)


Congenital Rubella Syndrome
one of ToRCHeS infection
Mother acquires infection via respiratory droplets
Rash, fever, lymphadenopathy


Classic triad in fetus:
Deafness
Cataracts
Cardiac disease


Congenital heart disease
Patent ductus arteriosus (PDA)
Pulmonary artery stenosis
Many others
Also petechiae/purpura ("blueberry muffin baby")


Babies excrete virus for months
Public health hazard


Diagnosis:
IgM antibodies (recent infection)
Amniocentesis (virus in amniotic fluid)




Newborn Deafness
CMV
Blueberry muffin baby
Seizures
Hepatosplenomegaly


Rubella
Blueberry muffin baby
Cataracts.
Congenital heart disease.