Critical points for this question: 5 year old boy, immunosuppressed because of chemotherapy, 2 day history of fever, cough, shortness of breath, febrile (101.8 F), respirations 46/min, with cyanosis and generalized vesicular rash. Extensive nodular infiltration.
Of the options listed only measles and VZV give a rash. A rash from measles usually starts rostrally and descends caudally, and is flat and erythematous. By contrast, VZV (chickenpox) presents with generalized rash that quickly transitions from macular to papular then to vesicular.
imnotarobotbutAlso, VZV causes pneumonia (what this patient probably had) and encephalopathy in the immunocompromised.+32019-06-25T17:59:20Z
nwinkelmannWhat threw me off was that it didn't mention the synchronicity of the rash. I stupidly took failure to mention to mean that the rash was synchronous, which doesn't fit VZV because chickenpox rash is characterized as a dyssynchronous rash (i.e. all stages of the macule to papule to vesicle to ulceration are seen at the same time). MUST REMEMBER: don't add information not given!+2019-07-09T00:11:56Z
jboud86If anyone wants to refresh info on Vaicella-Zoster virus, page 165 in FA 2019. +2019-08-11T23:32:37Z
Did anyone think that influenza was right? I understand that Herpes-Z can cause pneumonia but why is this answer better over influenza?
jrod77I believe it's the vesicular rash that gives it away. I thought it was influenza too, but i re-read the questions and I realized they included a rash which disqualifies influenza.+12019-06-04T20:08:29Z
charcot_bouchardAlso h/o of immunsupression, disseminated VZV. Influenza itself doesnt cause severe disease. secondary PNA does. which u will see in elderly. usually+2019-08-11T16:16:51Z
to snoo-finity ... and beyond!
submitted by sajaqua1(278), 2019-06-04T20:15:15Z
Critical points for this question: 5 year old boy, immunosuppressed because of chemotherapy, 2 day history of fever, cough, shortness of breath, febrile (101.8 F), respirations 46/min, with cyanosis and generalized vesicular rash. Extensive nodular infiltration.
Of the options listed only measles and VZV give a rash. A rash from measles usually starts rostrally and descends caudally, and is flat and erythematous. By contrast, VZV (chickenpox) presents with generalized rash that quickly transitions from macular to papular then to vesicular.