Rubella: diagnosis

Diagnosis of rubella is carried out on the basis of clinical and epidemiological data and a picture of blood.

The specific diagnosis of rubella is based on the use of RSK, RTGA, ELISA and RIF in paired sera. The determination of specific antibodies belonging to the IgM class is carried out no later than the 12th day after exposure to the source of the infection.

The overwhelming majority of patients can detect antibodies in high titers after the 7-10th day of the disease. The presence of rubella proves an increase in antibody titer in the second serum compared with the first in 4 times or more.

In recent years, the PCR method has been widely used, especially for the diagnosis of congenital rubella.

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Indications for consultation of other specialists

Rubella, which occurs with CNS involvement requires consultation of a neurologist.

Differential diagnosis of rubella

Differential diagnosis of rubella is carried out with measles, especially mitigated, pseudotuberculosis, infectious mononucleosis, enterovirus exanthema, sudden exanthema, toxicoallergic dermatitis.

Differential diagnosis of rubella

Nosological form	Similarities	Difference
Measles	Fever, rash, catarrhal phenomena, polyadenopathy	Fever from 3-4 to 10 days, febrile. Intoxication is expressed. The rash on the 4th-5th day is characterized by the stage of the rash. Elements of the rash are spotted-papular, grouped, merged with each other. Catarrhal phenomena are pronounced. Rough cough, scleritis, conjunctivitis, lacrimation. Lymph nodes of different groups are enlarged, but occipital nodes are rare. Before the appearance of the rash - the spots of the Belsky-Filatov-Koplik, Specific antibodies of the IgM class
Pseudotuberculosis (generalized form)	Fever, rash, catarrhal phenomena, arthralgia, polyadenopathy	Fever is high, prolonged, intoxicated. Symptoms of "hood", "gloves", "socks", abdominal pain, diarrhea, arthralgia at the height of the disease, rash on days 2-4, scarlet fever or spotty-papular, mainly around the joints. With subsequent peeling, micro-polyadenopathy without involvement of the occipital lymph nodes, Detection of specific antibodies
Infectious mononucleosis	Fever, polyadenopathy, rash, possible atypical mononuclear blood	Fever from 3-4 days to 3-4 weeks, predominantly lateral cervical lymph nodes, polyadenopathy prolonged, up to a month or more, a rash, usually (90%), appears after taking ampicillin on days 2-4 of the disease and later . Characterized by tonsillitis pharyngitis, it is possible hepatitis, In the blood leukocytosis. The content of atypical mononuclears is more than 10% in two or more analyzes; specific IgM antibodies to the capsid antigen: a positive Hoff-Bauer reaction
Enterovirus exanthema	Fever, rash, lymphadenopathy, catarrhal phenomena	Febrile fever up to 7 days, moderate intoxication, face hyperemia, rash on the 2-3 day fever, often meningitis, myalgia, herpagina. Lateral, cervical lymph nodes are mainly enlarged. Specific antibodies with a titer increase of 4 times in paired sera, positive PCR results
Sudden exanthema	Fever, rash, lymphadenopathy	Fever 3-5 days, body temperature up to 39 ° C and above, rash after lowering body temperature, mainly on the trunk, enlarged bovine lymph nodes. Specific antibodies to HHV-4
Toxicoallergic dermatitis	Rash, polyadenopathy	The rash is plentiful, draining, especially near the joints, the lymph nodes are small, the lymph nodes of various groups are affected, gingivitis, stomatitis

[3], [4], [5], [6], [7], [8],