Case history
Case history #1
A 35-year-old man presents with a 3-day history of low-grade fever, malaise, headache, and aching knees. That morning he developed a rash on his face, which has now spread to his chest and arms. His physical exam is notable for mild conjunctival injection, mild bilateral posterior auricular lymphadenopathy, and a discrete erythematous papular rash on his face, trunk, and upper arms. The patient is a business traveler from Nigeria who arrived in the United States a week prior to the onset of his illness. He is unaware of his immunization status and reports that a coworker with whom he had close contact had a similar rash recently.
Case history #2
A 2820-gram female infant is born to a 22-year old primigravid mother at approximately 38 weeks' gestation following an uncomplicated pregnancy. The baby has mild hepatosplenomegaly, numerous purplish firm nonblanching skin nodules, scattered petechiae, and a grade 3 continuous murmur audible at the left infraclavicular area. The baby's mother immigrated from Vietnam during the sixth month of her pregnancy; she cannot recall having been immunized in childhood.
Other presentations
Postnatal rubella infection may be complicated by overt arthritis. This is more common in adults and females and may persist for weeks to months. Thrombocytopenia occurs in approximately 1 out of 3000 cases, most commonly in children.[1] Serious hemorrhagic complications may occur. Rare complications include neurologic disorders, myocarditis, pericarditis, hepatitis, and bone marrow failure.
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