Coplic stains

Definition

The so-called Koplik spots are mucous membrane changes in the cheek area in the context of a measles infection. They show themselves in the form of circumscribed small reddenings with a white center. In colloquial language, they are therefore also called “lime splash spots”. Koplik spots only appear in the initial stage of the infection and are replaced in the further course of the disease by the typical fine spotted skin rash all over the body.

Causes

The cause for the appearance of Koplik spots in the cheek area is an infection with the measles virus. In most cases, the virus is transmitted via a droplet infection. In children, this means that contact with other sick children in particular is a high risk of infection.

The lime splatter-like spots appear at the beginning of the disease and are usually not noticed by the affected persons themselves or by their parents due to their localization in the inner mouth area. This also explains the high risk of infection with the virus in the early stages of the infection. It is not uncommon for many children to fall ill at the same time if they are not protected by a vaccination.

Koplik stains after vaccination

After an inoculation the appearance of Koplik spots is possible. The measles vaccination is a live vaccination, which can cause a so-called “vaccination-induced infection”. In simple terms, therefore, vaccination with the attenuated pathogens can cause a mild form of the actual disease. The “vaccination measles” occur within one to four weeks together with an increased body temperature. Usually the vaccination reaction is harmless and should be observed during the course of the disease.

Associated symptoms

Measles infection is a generalized viral disease. This means that it affects the entire body. Children therefore often show an elevated body temperature at the beginning of the disease, which is accompanied by a general feeling of illness.

Swollen lymph nodes in the neck area are also possible. It is therefore not uncommon for the early stages to resemble a cold. However, an important distinguishing feature is the two-phase course of fever.

Affected children therefore have a fever for a short time and are then free of fever for a short time, only to regain it again. In the first fever attack the Koplik spots appear and in the second the typical fine spotted skin rash all over the body.

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Koplik stains are not noticed by most children.

Rather, they suffer from the increased body temperature and feel flabby as a result. However, if the mucous membrane is additionally infected with bacteria, Koplik spots can also be painful. In most cases, however, it is rather a burning sensation on the mucous membrane that the children describe.

The sensation can be explained by the fact that the surface of the mucous membrane is attacked by the pathogens and reactively leads to the body’s own defence reaction. This then manifests itself in an inflammatory reaction, which can lead to pain with local redness. It is characteristic for Koplik spots to occur in the area of the cheek.

If small redness with a white center on the tongue occurs, it is in most cases not a phenomenon of measles infection. Especially when the observed changes on the tongue are very painful, it is more likely to be a fungal infection of the mucous membrane of the tongue. In the course of the disease, the spots then turn into a flat reddening with whitish areas.