Rubella - Diagnosis

Diagnosis of rubella is based on clinical and epidemiological data and blood picture.

Specific diagnostics of rubella is based on the use of RSK, RTGA, ELISA and RIF in paired sera. Determination of specific antibodies belonging to the IgM class is carried out no later than the 12th day after contact with the source of infection.

In the vast majority of patients, antibodies can be detected in high titers after the 7th to 10th day of illness. The presence of rubella is proven by an increase in the antibody titer in the second serum compared to the first by 4 times or more.

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

[ 1 ], [ 2 ]

Indications for consultation with other specialists

Rubella, which occurs with damage to the central nervous system, requires consultation with a neurologist.

Differential diagnosis of rubella

Differential diagnostics of rubella is carried out with measles, especially mitigated, pseudotuberculosis, infectious mononucleosis, enterovirus exanthema, sudden exanthema, toxic-allergic dermatitis.

Differential diagnosis of rubella

Nosological form	Similarity	Difference
Measles	Fever, rash, catarrhal symptoms, polyadenopathy	Fever from 3-4 to 10 days, febrile. Intoxication is expressed. Rash on the 4-5th day, the stages of the rash are characteristic. The elements of the rash are maculopapular, grouped, merge with each other. Catarrhal phenomena are sharply expressed. Rough cough, scleritis, conjunctivitis, lacrimation. The lymph nodes of various groups are enlarged, but the occipital ones are rare. Before the rash appears - Belsky-Filatov-Koplik spots, Specific antibodies of the IgM class
Pseudotuberculosis (generalized form)	Fever, rash, catarrhal symptoms, arthralgia, polyadenopathy	High fever, prolonged, severe intoxication. Symptoms of "hood", "gloves", "socks", Abdominal pain, diarrhea, arthralgia at the height of the disease, rash on the 2nd-4th days of the disease, scarlet fever-like or maculopapular, mainly around the joints. with subsequent peeling, micropolyadenopathy without involvement of the occipital lymph nodes, Detection of specific antibodies
Infectious mononucleosis	Fever, polyadenopathy, rash, possible atypical mononuclear cells in the blood	Fever from 3-4 days to 3-4 weeks, predominantly enlarged lateral cervical lymph nodes, polyadenopathy is prolonged, up to a month or more, Rash, as a rule (90%), appears after taking ampicillin on the 2nd-4th days of illness and later. Characteristic tonsillitis pharyngitis, possible hepatitis, Leukocytosis in the blood. The content of atypical mononuclear cells is more than 10% in two or more tests; specific antibodies IgM to the capsid antigen: positive Hoff-Bauer reaction
Enteroviral exanthema	Fever, rash, lymphadenopathy, catarrhal symptoms	Febrile fever up to 7 days, moderate intoxication, facial hyperemia, rash on the 2nd-3rd day of fever, often meningitis, myalgia, herpangina. Mainly lateral, cervical lymph nodes are enlarged. Specific antibodies with a 4-fold increase in titer in paired sera, positive PCR results
Sudden exanthema	Fever, rash, lymphadenopathy	Fever 3-5 days, body temperature up to 39 'C and higher, rash after a decrease in body temperature, mainly on the trunk, enlarged parotid lymph nodes. Specific antibodies to HHV-4
Toxic-allergic dermatitis	Rash, polyadenopathy	The rash is abundant, confluent, especially near the joints, the lymph nodes are small, lymph nodes of various groups are affected, gingivitis, stomatitis

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