Koplik spots

Koplik spots are described as grains of salt on a red background and represent tiny foci of necrosis with syncytial giant cells in the mucosal epithelium. Their timing is what makes them clinically valuable: they precede the exanthem, so they allow diagnosis and isolation during the period of maximum infectivity. The classic measles course is a prodrome of high fever with the three Cs (cough, coryza, conjunctivitis) followed by Koplik spots and then a maculopapular rash beginning at the hairline and behind the ears and spreading cephalocaudally to become confluent, later desquamating and darkening in a brownish, staining pattern. Measles is an enveloped, negative-sense, single-stranded RNA paramyxovirus, is among the most contagious infections known, and is prevented by the live attenuated MMR vaccine, which is contraindicated in pregnancy and severe immunodeficiency. Vitamin A reduces morbidity and mortality in children with measles.