A 2-year-old child has fever for 5 days, morbilliform rash, coryza, cough, and conjunctivitis. Just before the rash appeared, small white spots were seen on the buccal mucosa opposite the lower molars. The child was unvaccinated. The pathognomonic mucosal finding described is:
- A Forchheimer spots (soft palate petechiae)
- B Pseudomembrane on tonsils
- C Enanthem of hand-foot-mouth disease
- D Koplik spots ✓
Explanation
Koplik spots — small, irregular bright red spots with a central bluish-white speck on the buccal mucosa opposite the lower molars — are pathognomonic of measles (rubeola). They appear 1-2 days before the skin rash and fade as the rash develops. Measles classically presents with the 3 Cs (cough, coryza, conjunctivitis) and fever preceding the cephalocaudal morbilliform rash. Forchheimer spots (petechiae on soft palate) are characteristic of rubella. Pseudomembrane on tonsils suggests diphtheria. The enanthem of HFMD involves oral ulcerative lesions predominantly on the tongue and buccal mucosa in a specific distribution.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.