Koplik's spots
Koplik spots (also Koplik's sign) are a prodromic viral enanthem of measles manifesting two to three days before the measles rash itself. They are characterized as clustered, white lesions on the buccal mucosa (opposite the upper 1st & 2nd molars) and are pathognomonic for measles.[1] The textbook description of Koplik spots is ulcerated mucosal lesions marked by necrosis, neutrophilic exudate, and neovascularization.[2] They are described as appearing like "grains of salt on a wet background",[3] and often fade as the maculopapular rash develops. As well as their diagnostic significance they are important in the control of outbreaks. Their appearance, in contacts of a diagnosed case, before they reach maximum infectivity, permits isolation of the contacts and greatly aids control of this highly infectious disease.[4]
Nobel laureate John F. Enders and Thomas Peebles, who first isolated measles virus were careful to collect their samples from patients showing Koplik's spots.[5]
History
Koplik's spots are named after Henry Koplik (1858-1927), an American pediatrician who published a short description of them 1896, emphasising their appearance before the skin rash and their value in the differential diagnosis of diseases with which measles might be mistaken.[4][6] He published two further papers on the spots, including one with a colour illustration.[7] An anonymous reviewer of Koplik's The Diseases of Infancy and Childhood refers to the illustration as "the now famous coloured plate".[8]
Some authors ascribe the first written description of these spots to Reubold, Würzburg 1854, and others to Johann Andreas Murray (1740-1791). Before Koplik, the German internist Carl Jakob Adolf Christian Gerhardt (1833-1902) in 1874, the Danish physician N. Flindt in 1879, and the Russian Nil Filatov (1847-1902) in 1895, had observed equivalent phenomena.[9] Koplik was aware of Filatov's work,[10] thought his evidence insufficient and rejected his claim for priority.[7]
References
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External links
- Koplik spots in early measles - Canadian Medical Association Journal
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- ↑ Robbins and Cotran. "Infectious Diseases." Pathologic Basis of Disease. 7th ed. 2005. Print.
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- ↑ Koplik, H. "The diagnosis of the invasion of measles from a study of the exanthema as it appears on the buccal mucous membrane", Archives of Pediatrics, New York, 1896; 13: 918-922," (accessed 13 September 2006)
- ↑ Lua error in package.lua at line 80: module 'strict' not found.
