Rubella (German measles) was once a common childhood disease that had its highest incidence during the spring. The incubation period is 12 to 25 days following exposure with a 1- to 5-day prodrome of fever, malaise, headache, and sore throat.
The exanthem varies and is sometimes difficult to identify. It may present as a short-lived blush, or it may have the more common 2- to 3-day course. The exanthem begins as irregular pink macules and papules on the face spreading to the neck, trunk, and arms in a centrifugal distribution. It coalesces on the face as the eruption reaches the lower extremities and then clears in the same fashion. As enanthem of pinpoint petechiae involving the soft palate (Forschheimer spots) may accompany the rash but is nonspecific.
Lymphadenopathy is a clinical manifestation of rubella, with the enlargement characteristically in the suboccipital and posterior auricular nodes. The clinical diagnosis of the individual case is often difficult, but the epidemic nature of the illness, along with the seasonal variation and high expression rate of the exanthem, help in establishing the diagnosis. A history of inadequate immunizations may assist in the diagnosis. There is no specific therapy.
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