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Rubella - Skin in Adult
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Rubella - Skin in Adult

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Contributors: Noah Craft MD, PhD, Lindy P. Fox MD, Lowell A. Goldsmith MD, MPH, Michael D. Tharp MD
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Synopsis

Rubella (German measles) is caused by the rubella virus, which is an RNA virus in the Togaviridae family. Transmission is through the respiratory route. Its incubation period is 14–21 days. A prodrome of irritability, malaise, mild conjunctivitis, headache, fever, adenopathy, and minimal respiratory symptoms may appear 1–7 days prior to the cutaneous eruption. An exanthematous eruption starting on the face and spreading caudally then typically appears. This rash may be absent in as many as 25% of cases.

Infection in the United States is rare, owing to widespread vaccination. There is a higher incidence in confined populations such as military bases and schools. The disease is more common in the spring and summer. Arthralgias and mild arthritis, splenomegaly, thrombocytopenia, and testicular pain are sometimes seen. Encephalitis occurs in 1 out of 6,000 cases. Pain on lateral or upward eye movement is common in this disorder. Thrombocytopenic purpura is also a rare complication.

Even in the immunocompromised host, rubella is usually a benign illness. The major impact of rubella is on the fetus of a pregnant woman and is one of the TORCH (toxoplasmosis, other [bacterial, sepsis, syphilis], rubella, CMV, and herpes simplex) diseases. These disorders can cause fetal heart and eye malformations, cataracts, deafness, retardation, thrombocytopenic purpura, hepatosplenomegaly, intrauterine growth retardation, interstitial pneumonia, myocarditis, myocardial necrosis, and metaphyseal bone lesions may occur.

Codes

ICD10CM:
B06.9 – Rubella without complication

SNOMEDCT:
36653000 – Rubella

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Because most people in the United States have been immunized, the disease is rare there. Rubella should be most suspected in disadvantaged populations, migrant workers, new immigrants, etc.

Best Tests

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Management Pearls

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Therapy

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References

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Last Updated: 12/08/2014
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Rubella - Skin in Adult
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Rubella (Adult) : Fever, Headache, Rash, Polyarthralgia, Rhinorrhea, Widespread, Conjunctival injection
Clinical image of Rubella
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