A 26-year-old man complains of chills, rhinitis, dry cough, and fever up to 38°C. Examination shows him to be in a moderately severe condition; there are small Pale pink non-merging spots on the skin of is back, abdomen, and extremities. Palpation reveals enlarged occipital and axillary lymph nodes. No information about vaccination history could be obtained. What is the likely etiology of this disease?

Answer options

1. Meningococcus
2. Epslein-Barr virus
3. Rubella virus
4. Mumps virus
5. Streptococcus

Explanation

An acute febrile illness (fever up to 38 °C, chills) associated with upper respiratory tract affection (rhinitis, dry cough), rash, and poly lymphadenopathy (palpation reveals enlarged occipital and axillary lymph nodes) in a person who has not been immunized (no information about vaccination history could be obtained) is suggestive of rubella. Moreover, the rash described (small pale pink nonemerging spots on the skin of the back, abdomen, and extremities) is typical for rubella, and enlargement of occipital lymph nodes is a pathognomonic sign of this disease. Rubella, also known as German measles, is caused by the rubella virus, a member of the Togaviridae, which is a single-stranded RNA virus 1. Harrison’s Principles of Internal Medicine / D. L. Kasper et al. – 19th Ed. – McGraw-Hill, 2015. – P. 1299. 2. Infectious Diseases / J. Cohen et al. – 3rd Ed. – Mosby, 2010. – P. 102