Presentation
History
The incubation period of rubella is 14-23 days.
The prodrome is characterized by the following:
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Malaise
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Fever
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Anorexia
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Headache
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Mild conjunctivitis
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Rhinorrhea
The rash develops within 1-5 days of symptom onset, starting on the face and forehead and spreading caudally to involve the trunk and extremities.
The rash tends to clear in the same order as it appeared.
The rash may be pruritic, but it usually resolves within 3 days without residua.
Next:
Physical Examination
Lymphadenopathy may be present, particularly in the posterior auricular, posterior cervical, and suboccipital chains.
The rash consists of pink macules and papules, which may become confluent, resulting in a scarlatiniform eruption.
Petechiae of the soft palate, known as the Forchheimer sign, may be present.
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Media Gallery
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Image in a 4-year-old girl with a 4-day history of low-grade fever, symptoms of an upper respiratory tract infection, and rash. Courtesy of Pamela L. Dyne, MD.
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