Question
Patient Age: 1 year Detailed Condition and Purpose of Consultation: My 8-month-old son has been running a fever of 39 degrees Celsius recently. After the fever subsided, he developed red rashes. Blood test results show a white blood cell count of 28, and the doctor diagnosed it as measles. However, after searching online, the symptoms seem more consistent with rubella. How can I differentiate between these two diseases? Duration of Illness and Continuation: 1 day Current General Condition: Lymph nodes are swollen Auxiliary Examination: White blood cell count of 28
Answer
Measles typically has a history of contact, with rashes first appearing behind the ears, at the hairline, and around the neck, expanding within 24 hours to the forehead, trunk, and upper arms. By the third day, they spread to the lower limbs and feet. The rashes start as rose-colored macules and then deepen to dark red, often merging into patches. The presence of multinucleated giant cells in nasopharyngeal secretions and inclusion bodies in urine can aid in early diagnosis.Measles antibody testing can be confirmed by ELISA within 1-2 days after the rash appears. Rubella is characterized by low fever, with rashes rapidly spreading throughout the body within 24 hours, but typically without rashes on the palms and soles. After the rash fades, there is no desquamation or hyperpigmentation. Lymph nodes behind the ears and at the nape are swollen and painful. Rubella can be quickly diagnosed by detecting IgM antibodies and specific IgG avidity in the serum.