Pt without** fever, immunizations UTD, no known sick contacts, no known recent bites/stings, no recent travel, no new medications, and no changes to regular diet.

 

 

ENTEROVIRUSES:
febrile with GI symptoms, possibly meningitic symptoms, respiratory infections.
Usually with fairly diffuse rashes.
There is no treatment so exclude other dx and tx symptoms.
Tx: Antipyretics and hydration. Maalox and benadryl liquid can be applied to oral lesions; don’t use viscous lido!

Echovirus A9: Spreads Head –> Toe

Coxsackie Virus A9 (Hand-Foot-Mouth): often misinterpreted with Herpangina

MEASLES:
Exposure within about ten days of symptom start
THEN 3 days fever+ malaise +anorexia 
THEN Cough, coryza, conjunctivitis 
THEN rash beginning 14 days after exposure from hairline moving downward over trunk (sparing palms and soles).
If suspicious even with no exanthem, KOPLIK spots are pathognomonic for measles and usually appear 2 days ahead of rash
Tx: