Measles — MRCPCH FOP MCQ

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A 3-year-old unvaccinated boy has fever, cough, conjunctivitis and a widespread maculopapular rash starting behind the ears. Small white spots are seen on the buccal mucosa. What is the most likely diagnosis?

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Correct answer: A — Measles

Fever with cough, conjunctivitis, Koplik spots and cephalocaudal rash spread is typical of measles. Scarlet fever usually has sore throat, strawberry tongue and sandpaper rash rather than conjunctivitis and Koplik spots. Roseola classically has fever that resolves as the rash appears. The pearl is that suspected measles requires infection control and notification.

Reference: UKHSA Green Book Measles; NICE CKS Measles