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Vitamin A
79%
247/311
Vitamin D
2%
5/311
Vitamin E
6%
19/311
Vitamin K
4%
12/311
Vitamin B6
8%
24/311
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The infant likely has measles based on her history, presence of Koplik spots on her oral mucosa, rash, and croup. Vitamin A supplementation is used in treating measles. Vitamin A is believed to activate the immune system during an infection. Studies have shown that those deficient in vitamin A have a higher mortality rate from measles infection which has led to the recommendation for vitamin A supplementation during infections such as measles. Vitamin A is a fat-soluble vitamin that plays many important roles, including maintenance of vision (deficiency causes night blindness), and of epithelial growth and repair. Though measles was declared eradicated in the US, cases are still seen in unvaccinated foreign-born persons or unvaccinated persons who travel to a measles-endemic country. McKinnon and Howard review evaluation of the febrile infant with rash. They note that measles (or rubeola) is a viral illness that begins with URI symptoms or croup-like cough and fever with Koplick spots, progressing by the fourth day into a macular-papular rash that begins on the face and neck and spreads centrifugally. Huiming et al. in a Cochrane review discuss the use of vitamin A supplementation in treating the measles. They conclude that though no overall reduction in mortality for all children of measles with Vitamin A supplementation, children under 2 years old did have benefit from 2 doses on overall mortality and pneumonia-specific mortality. Figure A shows Koplick spots, the characteristic red spots with blue and white centers that occur as part of the measles prodrome. Illustration A shows a characteristic measles rash. Incorrect Answers: Answers 2-5: These vitamins are not useful in treating measles.
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