Diagnosis of Rubella
Diagnostic Test list for Rubella:
The list of medical tests
mentioned in various sources as
used in the diagnosis of Rubella
includes:
- Rubella virus antibody blood test
Rubella Diagnosis: Book Excerpts
Diagnostic Tests for Rubella: Online Medical Books
16 MEDICAL BOOKS ONLINE!
Review excerpts from medical books online, free, without registration,
for more information about diagnostis of Rubella.
Rubella:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
The rubella rash, lymphadenopathy, other characteristic signs, and a history of exposure to infected people usually permit clinical diagnosis without laboratory tests.
CONFIRMING DIAGNOSIS The rubella rash has been confused with scarlet fever, measles (rubeola), infectious mononucleosis, roseola, erythema infectiosum, and other viral exanthems. Therefore, without exposure history, laboratory confirmation is beneficial. Cell cultures of the throat, blood, urine, and cerebrospinal fluid can confirm the virus’ presence. Convalescent serum that shows a fourfold rise in antibody titers corroborates the diagnosis.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Rubella:
Diagnosis
(Handbook of Diseases)
The rubella rash, lymphadenopathy, other characteristic signs, and a history of exposure to infected people usually permit clinical diagnosis without laboratory tests. However, cell cultures of the throat, blood, urine, and cerebrospinal fluid can confirm that the virus is present. Convalescent serum that shows a fourfold rise in antibody titers confirms the diagnosis.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Jaundice - Case 15-1: 14-Day-Old Boy:
I. History of Present Illness
(Pediatric Complaints and Diagnostic Dilemmas)
A 14-day-old, full-term male infant was transferred from a local community
hospital for further evaluation and management of sepsis and
hyperbilirubinemia. He had been discharged home from the well-baby nursery on
the fourth day of life with a bilirubin concentration of 16.7 mg/dL. Two days
later, his bilirubin level was 19.4 mg/dL and he was admitted for phototherapy.
Within 48 hours after admission, he developed emesis and temperature
instability. A blood culture and lumbar puncture were performed, and ampicillin
and gentamicin were started. Additional bilirubin measurements revealed the
direct fraction to be 5.2 mg/dL. An ultrasound study, performed to assess
hepatomegaly, revealed a nondilated biliary system, small gall bladder, and
diffuse hepatic enlargement. A nuclear medicine liver scan did not show bile
excretion after 4 hours, prompting initiation of phenobarbital therapy.
The baby continued to receive breast milk feedings (with nasogastric tube
supplementation required because of poor oral intake) until he experienced
blood-tinged emesis. Coagulation studies at that time revealed the prothrombin
time (PT) to be greater than 50 seconds and the partial thromboplastin time
(PTT) to be greater than 200 seconds; for this reason, vitamin K and a dose of
fresh-frozen plasma were given. By report, the baby
's abdomen was soft and his stool quantity and quality were unremarkable.
Transfer to a tertiary care center was arranged.
II. Past Medical History
The baby was born to a 27-year-old gravida 1 parity 0 mother with unremarkable
prenatal laboratory values. Delivery was via cesarean section at 37 weeks
because of breech presentation. The baby
's birth weight was 3.04 kg. He was discharged with his mother on the fourth day
of life and was breast-feeding every 3 hours.
III. Physical Examination
T, 36.4°C; RR, 48/min; HR, 140 bpm; BP, 83/50 mm Hg
Weight, 2.7 kg
Physical examination revealed a 2-week-old term boy who was listless but
arousable. His skin demonstrated a yellow-green jaundice but no petechiae,
rash, or bruising. He was nondysmorphic and normocephalic, with an open, flat
fontanel. His pupils were equal, round, and reactive with red reflexes present
bilaterally. Mucous membranes were yellow-pink and slightly dry. His
respirations were slightly rapid but otherwise unlabored with clear breath
sounds bilaterally. The heart examination was normal. The abdomen was soft and
nondistended, with a smooth, firm liver edge palpable 3 cm below the right
costal margin. Examinations of the genitalia and extremities were normal. His
tone, power, and primitive reflexes all appeared to be within normal limits.
IV. Diagnostic Studies
A complete blood count revealed the following: white blood cells (WBCs),
9,400/mm
3 (1% band forms, 41% segmented neutrophils, and 45% lymphocytes); hemoglobin,
16.0 g/dL; and platelets, 66,000/mm
3. PT and PTT were markedly prolonged at 50 and 112 seconds, respectively.
Fibrinogen was 127 mg/dL, and fibrin split products were negative. Serum
bicarbonate was 17 mEq/L, but the remainder of the serum electrolytes, calcium,
magnesium, and phosphorus were normal. Serum glucose was 52 mg/dL. A hepatic
function panel revealed the following: alanine aminotransferase (ALT), 115 U/L
aspartate aminotransferase (AST), 126 U/L; alkaline phosphatase, 730 U/L;
γ-glutamyl transferase (GGT), 55 U/L; and albumin, 3.5 mg/dL. The unconjugated
bilirubin concentration was 13.1 mg/dL, and the conjugated bilirubin was 5.9
mg/dL.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Seizures - Case 19-1: 8-Day-Old Girl:
I. History of Present Illness
(Pediatric Complaints and Diagnostic Dilemmas)
An 8-day-old girl presented to the emergency department after an episode of
irregular, rapid breathing followed by stiffening of her body and shaking of
her extremities that lasted several seconds. On arrival, the infant was
lethargic, cyanotic, and bradycardic with minimal spontaneous respirations. She
underwent emergency endotracheal intubation and received multiple boluses of
normal saline, with improvement in her perfusion and heart rate.
She then had a generalized seizure and received intravenous lorazepam.
Ampicillin and cefotaxime were administered after a blood culture was obtained.
According to the family, she had fed poorly that day and had been sleeping more
than usual. The infant had been afebrile and had had normal stooling and urine
output. There was no vomiting, diarrhea, or rashes. There were no ill contacts.
II. Past Medical History
The infant weighed 3,400 g at birth and was the product of a full-term
gestation. She was born by spontaneous vaginal delivery after an uncomplicated
pregnancy. Maternal serology was negative. The infant
's postnatal course was remarkable only for mild jaundice that did not require
phototherapy. The mother denied a history of genital HSV infection. There was
no family history of seizures.
III. Physical Examination
T, 39.0°C; RR, 20/min; HR, 180 bpm; BP, 86/45 mm Hg; SpO2, 100% in room air
Weight, 25th percentile; head circumference, 50th percentile
Examination revealed a mechanically ventilated infant. She was sedated but
withdrew in response to painful stimuli. The fontanel was bulging. There were
no head lacerations or skull depressions. The sclerae were anicteric, and the
pupils were 1.5 mm and symmetrically reactive. There were no cardiac murmurs,
and the femoral pulses were weakly palpable. The lungs were clear to
auscultation. The abdomen was soft, and the umbilical stump was well healed
without erythema or discharge. There were two pustules in the perineal area.
IV. Diagnostic Studies
Laboratory results were as follows: sodium, 132 mEq/L; potassium, 3.3 mEq/L;
chloride, 99 mEq/L; bicarbonate, 23 mEq/L; glucose, 73 mg/dL; calcium, 8.9
mg/dL; and magnesium, 2.1 mg/dL. The complete blood count revealed 8,000
WBCs/mm
3, including 33% band forms, 18% segmented neutrophils, 35% lymphocytes, and 10%
monocytes. The hemoglobin and platelet count were normal. On cerebrospinal
fluid (CSF) examination, there were 879 WBCs/mm
3 (48% segmented neutrophils, 19% lymphocytes, and 33% monocytes) and 1,739 red
blood cels/mm
3; no organisms were seen on Gram staining. The CSF glucose concentration was 36
mg/dL, and the protein concentration was 400 mg/dL. CSF was sent for bacterial
culture and detection of HSV by polymerase chain reaction (PCR). There were no
abnormalities on chest radiograph.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Seizures - Case 19-2: 10-Day-Old Boy:
I. History of Present Illness
(Pediatric Complaints and Diagnostic Dilemmas)
A 10-day-old boy was well until the day of admission, when he was noted by his
mother to have the sudden onset of left arm and leg shaking while sleeping. The
episode lasted about 1 minute and was accompanied by eyelid fluttering. After
spontaneous cessation of the episode, the infant continued sleeping but aroused
easily. He was brought to the emergency department for evaluation. He did not
have fever or cyanosis. There was no recent vomiting or diarrhea. His oral
intake had been unchanged over the past several days and consisted exclusively
of cow milk-based formula every 2.5 to 3 hours. The parents were uncertain
about urine output because the maternal grandmother had cared for the infant on
the day before admission.
II. Past Medical History
The infant weighed 3,600 g at birth. He was born by spontaneous vaginal delivery
after an uncomplicated pregnancy. He required phototherapy briefly on the
second day of life for hyperbilirubinemia with a peak total bilirubin level of
15.5 mg/dL. The mother had vaginal colonization with group B
Streptococcus and received two doses of penicillin during labor. She also had a history of
genital HSV infection. Although no lesions were noted at delivery, she did
develop lesions on the seventh postpartum day.
III. Physical Examination
T, 37.5°C; RR, 40/min; HR, 124 bpm; BP, 75/45 mm Hg; SpO2, 100% in room air
Weight, 50th percentile; length, 25th percentile; head circumference, 25th
percentile
The infant appeared alert. There were no vesicles on the scalp or skin. His
anterior fontanel was open and flat. His conjunctivae were pink and anicteric.
Red reflex was present bilaterally. There was no murmur on cardiac examination,
and femoral pulses were strong. The spleen tip was just palpable, and there was
no hepatomegaly. The Moro reflex was symmetric. The remainder of the
examination was also normal.
IV. Diagnostic Studies
A complete blood count revealed 8,800 WBCs/mm3 (16% segmented neutrophils, 70% lymphocytes, 11% monocytes, and 3% atyptical
lymphocytes); hemoglobin, 13.4 g/dL; and platelets, 511,000/mm
3. Serum chemistry values included sodium, 139 mmol/L; potassium, 5.5 mmol/L;
chloride, 104 mmol/L; and bicarbonate, 28 mmol/L. The blood urea nitrogen and
creatinine concentrations were normal. Serum alanine and aspartate
aminotransferases were normal. Serum albumin was 3.3 g/dL. Examination of the
CSF revealed the following: WBCs, 12/mm
3; red blood cells, 1,834/mm3; glucose, 45 g/dL; and protein, 124 g/dL. There were no bacteria on Gram
staining.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
German Measles (Third Disease, Rubella):
German Measles - DIAGNOSIS
(The 5-Minute Pediatric Consult)
If rubella suspected, should be reported to local public health authorities
» READ BOOK EXCERPT ONLINE »
Source: The 5-Minute Pediatric Consult, 2008
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