<prompt> Koplik spots are seen inMeaslesMumpsRubellaDiphtheria  <response>: Ans. a Measles. Ref. Harrison, Medicine, 18thTable 17-1; Figure e7-2Kopliks spots, which manifest as white or bluish lesions with an erythematous halo on buccal mucosa, usually occur in the first 2 days of measles and may briefly overlap the measles exanthem. Presence of the erythematous halo differentiates Kopliks spots from Fordyces spots ectopic sebaceous glands, which occur in the mouths of healthy individuals.MEASLES rubeola It is caused by a paramyxovirus, which is spread by respiratory droplets produced by sneezing or coughing. Most infectious of all microbial agents. Maternal antibodies protect for 6 months. The measles incubation period is 8-15 days. Classically, measles is preceded by the three Cs:- Hacking cough,- Coryza nasal rhinorrhea and congestion, and- Conjunctivitis, plus photophobia, malaise, and a high fever persisting for several days. Part of the enanthem is called Kopliks spots which appear on or after the second day of fever.- Prodromal illness, 1-3 days heralds catarrhal stage.- Catarrhal stage is characterized by respiratory symptoms and Koplik spots. Koplik spots pathognomonic of measles are seen on buccal mucosa opposite to 2nd upper molar tooth. Kopliks spots develop on the buccal mucosa 2 days before the rash appears. The characteristic rash of measles begins 2 weeks after infection, when the clinical manifestations are most severe, and signal the hosts immune response to the replicating virus. The exanthem classically appears on the fourth day of fever. Rash is morbilliform means measles-like. RASH appears as natural antibody develops, lasts 5-6 days and then gradually fades with pigmentation. Generalized lymphadenopathy, diarrhea, convulsions and bacterialHoest pneumonia can occur. SSPE is a rare and late complication, after 6-7 years. Edmonsten Zagreb strain is used in vaccine preparation. The current monovalent attenuated live virus vaccine Attenuvax contains the Moraten more attenuated strain of measles virus, which effectively confers immunity while reducing the incidence of adverse events following vaccination.Diseases Associated with Fever and RashDiseaseEtiologyDescriptionClinical SyndromeRubeola measles, first diseaseParamyx ovirusDiscrete lesions that become confluent as rash spreads from hairline downward, sparing palms and soles; lasts 3 days; Kopliks spotsCough, conjunctivitis, coryza, severe prostrationRubella German measles, third diseaseTogavirusSpreads from hairline downward, clearing as it spreads; Forscheimer spotsAdenopathy, arthritisErythema infectiosum fifth diseaseHuman parvovirus B19Most common among children 3-12 y old;Bright-red slapped-cheeks appearance followed by lacy reticular rash that waxes and wanes over 3 weeks; rarely, papular-purpuric gloves-and-socks synd on hands and feet.Mild fever; arthritis in adults; rash following resolution of feverDiseaseEtiologyDescriptionClinical SyndromeExanthem subitum roseola, sixth diseaseHuman herpesvirus 6Usually affects children 3 years old; Diffuse maculopapular eruption over trunk and neck; resolves within 2 daysRash following resolution of fever; similar to Boston exanthem echovirus 16; febrile seizures 