A nurse is assessing a child who was recently adopted from a foreign country and has not yet received any immunizations. The child has a high fever, rhinitis, and sore throat: The nurse also notes small, irregular, bright red spots with a blue-white center on the buccal membrane. What would the nurse suspect?
A.
Rubella
B.
Varicella
C.
Rubeola
D.
Infectious Mononucleosis
The correct answer and Explanation is :
The correct answer is C. Rubeola.
Explanation:
The clinical presentation described—high fever, rhinitis, sore throat, and the characteristic “Koplik spots” on the buccal membrane—strongly suggests measles, also known as rubeola. Koplik spots are small, irregular, bright red spots with a bluish-white center found on the buccal mucosa, typically opposite the molars, and are considered pathognomonic for measles. These spots usually appear a few days before the onset of the rash, which starts at the hairline and then spreads downward.
Measles (Rubeola) is a highly contagious viral disease caused by the measles virus. It commonly presents with a prodrome of high fever, cough, coryza (runny nose), and conjunctivitis. Following this, the characteristic rash develops, which usually starts on the face and then spreads to the trunk and extremities. The disease can be particularly severe in young children and those with compromised immune systems, making early recognition and management crucial.
Rubella (Option A), also known as German measles, typically presents with a mild rash that begins on the face and spreads to the rest of the body, but it does not have Koplik spots and often has a less severe fever and fewer prodromal symptoms compared to rubeola.
Varicella (Option B), or chickenpox, starts with a fever and a rash that progresses from macules to papules and then to vesicles (blisters), often with lesions at different stages of development, but it does not present with Koplik spots or the same prodromal symptoms as rubeola.
Infectious Mononucleosis (Option D) caused by Epstein-Barr virus often presents with symptoms like fever, sore throat, and lymphadenopathy, but it does not typically include Koplik spots or a rash that resembles that of measles.
Thus, the specific finding of Koplik spots along with the symptoms of fever, rhinitis, and sore throat points to rubeola (measles) as the most likely diagnosis.