German measles rubella

Although German measles is a benign disease of children, it is serious if it develops in a pregnant woman during the first trimester, because it causes anomalies in a low percentage of newborns.

The incubation period is around 18 days, and, as in measles, there may be a short prodromal stage of fever and malaise. The rash also resembles measles, because it occurs first on the face and then spreads. However, the redness is less intense and the rash disappears within 2 to 3 days. Enlargement of the cervical and the postauricular nodes is a characteristic finding.

Serious complications are rare.

Differential Diagnosis

Measles: Koplik spots; the fever and the rash are more severe; no postauricular nodes (see previous section).

Scarlet fever: High fever; perioral pallor; rash may be similar (see Chap 15).

Drug eruption: Get new drug history: usually no fever (see Chap 9).


PROPHYLACTIC. Rubella virus vaccine, live, attenuated, can be administered.

ACTIVE. Active treatment is usually unnecessary. Immune globulin given to an exposed pregnant woman in the first trimester of pregnancy may prevent the disease. Congenital Rubella Syndrome

Infants born to mothers who had rubella in the first trimester of pregnancy can have multiple system abnormalities. The skin lesions include thrombocytopenic purpura; hyperpigmentation of the navel, forehead, and cheeks; acne; seborrhea; and reticulated erythema of the face and extremities.

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