Infectious diseases. Measles. Clinic. Diagnostics. Treatment (most important)

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Infectious diseases. Measles. Clinic. Diagnostics. Treatment (most important)

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40. Measles. Clinic. Diagnostics. Treatment

Clinical manifestations. The incubation period is 10-12, less often 6-10 days, and the rash appears after 14 days. Body temperature may rise slightly on the 9-10th day, and then again decreases for a day or more.

The prodromal period, usually lasting 3-5 days, is characterized by fever, dry, "barking" cough, rhinitis, and conjunctivitis. 2-3 days before skin rashes, a symptom pathognomonic for measles appears - Koplik's spots (grayish-white spots the size of a grain of sand, surrounded by a reddish rim), usually located on the hard and soft palate.

Occasionally, the prodromal period is difficult, starting with a sudden increase in body temperature, convulsions, and even pneumonia.

Usually, rhinitis, fever and cough gradually increase, reaching a maximum by the time the rash appears.

Body temperature rises to 39-40,5 ° C simultaneously with a rash on the skin. In uncomplicated cases, after 2 days, when the rash covers the entire trunk and legs, the symptoms begin to disappear quickly.

The rash first appears as pale spots on the upper sides of the neck, behind the ears, along the hairline.

Within 24 hours, it rapidly spreads to the entire face, neck, arms, and upper chest.

Individual elements become maculopapular in nature. Over the next 24 hours, the rash spreads to the back, abdomen, and extremities. On the 2nd or 3rd day, it appears on the feet and at the same time begins to turn pale on the face. The rash turns pale and disappears in the same sequence as it appears. The severity of the disease is directly dependent on the severity of the rashes and their tendency to merge.

Lymph nodes in the angle of the mandible and the posterior neck are usually enlarged, and the spleen may also be slightly enlarged.

Young children with malnutrition are more likely to experience otitis media, bronchopneumonia, and gastrointestinal disturbances such as diarrhea and vomiting. Measles often affects children under the age of 1 year, and malnutrition contributes to the severe course of the disease.

Diagnosis. For the diagnosis of measles, mainly clinical and epidemiological data are used, and less often laboratory data, which include hematological data, cytological examination of nasal discharge, virus isolation, and detection of antibodies.

Treatment. Of paramount importance are bed rest, sedatives, and at high temperature, antipyretics and adequate fluid supply. Humidification of the air in the room may be necessary for laryngitis and severe irritating cough, with photophobia, the patient is protected from exposure to bright light.

When complicated by otitis media and pneumonia, appropriate antibacterial treatment is required. Children with encephalitis, sclerosing panencephalitis, giant cell pneumonia, disseminated intravascular coagulation require an individual approach and qualified care.

Author: Pavlova N.V.

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