Koplik's spots

Source: Wikipedia, the free encyclopedia.
Koplik's spots in the mouth of a child with measles, appearing as "grains of salt on a reddish background."[1]

Koplik's 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.[2] The textbook description of Koplik spots is ulcerated mucosal lesions marked by necrosis, neutrophilic exudate, and neovascularization.[3] They are described as appearing like "grains of salt on a reddish background",[1] 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 context of a diagnosed case, before they reach maximum infectivity, permits isolation of the contacts and greatly aids control of this highly infectious disease.[4]

John F. Enders and Thomas Peebles, who first isolated the measles virus, were careful to collect their samples from patients showing Koplik's spots.[5]

History

Koplik's spots are named after

pediatrician who published a short description of them in 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

  1. ^
    PMID 19255085
    .
  2. PMID 16481641
    .
  3. ^ Robbins and Cotran. "Infectious Diseases." Pathologic Basis of Disease. 7th ed. 2005. Print.
  4. ^
    S2CID 42670134
    .
  5. S2CID 4010044
    .
  6. ^ Koplik, H (1896). "The diagnosis of the invasion of measles from a study of the exanthema as it appears on the buccal mucous membrane". Arch Pediatr. 13: 918–22.
  7. ^ a b Koplik, Henry (1899). "the new diagnostic spots of measles on the buccal and labial mucous membranes". Med. News, (NY). 74: 673–6.
  8. doi:10.1016/s0140-6736(00)67711-5
    .
  9. ^ "Koplik's spots". www.whonamedit.com. Retrieved 2023-11-30.
  10. doi:10.1016/s0140-6736(01)71368-2. Archived
    from the original on 2020-01-11. Retrieved 2019-09-09.

Further reading

External links
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