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Rubella - Skin in Child
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Rubella - Skin in Child

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Contributors: Sarah Stein MD, Karen Wiss MD, Sheila Galbraith MD, Craig N. Burkhart MD, Dean Morrell MD, Lynn Garfunkel MD, Nancy Esterly MD
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Synopsis

Rubella (German measles) is caused by the rubella virus, which is a togavirus RNA virus. Transmission is through the respiratory route. The incubation period is 14–21 days. A prodrome of irritability, malaise, mild conjunctivitis, headache, and fever up to 38.3°C (100.94°F), adenopathy, and minimal respiratory symptoms may appear 1–7 days prior to the cutaneous eruption. Adenopathy precedes the exanthem.

The disease is rare in the United States due to mandated 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.

Even in the immunocompromised host, rubella is usually a benign illness. If the patient is female and of child-bearing age, note that the major impact of rubella is on the fetus and is one of the TORCH (toxoplasmosis, other [bacterial diseases, sepsis, syphilis], rubella, cytomegalovirus [CMV], and herpes simplex virus [HSV]) diseases. These disorders can cause fetal heart and eye malformations, deafness, retardation, thrombocytopenic purpura, hepatosplenomegaly, intrauterine growth retardation, interstitial pneumonia, myocarditis, myocardial necrosis, and metaphyseal bone lesions.

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 Child
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Rubella (Adult) : Fever, Headache, Rash, Polyarthralgia, Rhinorrhea, Widespread, Conjunctival injection
Clinical image of Rubella
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