Rubella

Bolognia
Rubella typically presents after an incubation period of 1618 days with
a mild prodrome that includes fever, headache and upper respiratory
symptoms. In children, many cases are subclinical. One to 5 days
following the prodrome, an eruption of erythematous macules and
papules appears on the face, spreading in a cephalocaudad direction.
Erythematous petechial macules may also be present on the soft palate
(Forchheimers spots). The eruption is often accompanied by tender
lymphadenopathy, especially of the occipital, posterior auricular and
cervical regions. The cutaneous eruption tends to fade in 23 days in
the same order as it appeared.
Complications of rubella include arthralgias and arthritis (especially
in postpubertal women), and, less frequently, hepatitis, myocarditis,
pericarditis, hemolytic anemia and thrombocytopenic purpura.
Encephalitis has been reported in 1 in 6000 cases12.
Rubella can be diagnosed by detection of antirubella IgM antibodies
or a fourfold increase in specific IgG antibodies. The exanthem of
rubella is fairly non-specific and the differential diagnosis includes
other exanthems (e.g. adenovirus, enterovirus, measles, EBV) and toxinmediated
eruptions such as scarlet fever. The occipital lymphadenopathy
and the typical progression of the eruption can be helpful in diagnosing
the disease.

Rubella biasanya menyajikan setelah masa inkubasi 16-18 hari dengan prodrome ringan yang
meliputi demam, sakit kepala dan gejala pernapasan atas. Pada anak-anak, banyak kasus yang
subklinis. Satu untuk 5 hari setelah prodrome, letusan makula eritematosa dan papula muncul
di wajah, menyebar ke arah cephalocaudad. makula petekie eritematosa juga dapat hadir pada
langit-langit lunak (bintik Forchheimer ini). Letusan ini sering disertai dengan lembut
limfadenopati, terutama dari oksipital, auricular posterior dan
daerah serviks. Letusan kulit cenderung memudar dalam 2-3 hari di
urutan yang sama seperti yang muncul. Komplikasi rubela termasuk arthralgia dan arthritis
(terutama pada wanita pascapubertas), dan, lebih jarang, hepatitis, miokarditis, perikarditis,
anemia hemolitik dan thrombocytopenic purpura.
Ensefalitis telah dilaporkan pada 1 6000 cases12.
Rubella dapat didiagnosis dengan deteksi antirubella antibodi IgM atau meningkat empat kali
lipat antibodi IgG spesifik. The exanthem rubella cukup non-spesifik dan diagnosis diferensial
meliputi exanthems lainnya (misalnya adenovirus, enterovirus, campak, EBV) dan letusan
toxinmediated seperti demam scarlet. Limfadenopati oksipital dan perkembangan khas letusan
dapat membantu dalam mendiagnosis penyakit.