Enlarged lymph nodes
Lymph nodes may appear with or without the skin rash, but it is more likely a part of the prodromal symptoms as well. These anatomical structures are located all over the course of the lymphatic vessels, and they have clusters of white blood cells ready to replicate and create body defenses against invaders. Lymph nodes are usually the first place where the inflammatory and immune reaction starts, and when it does, they start swelling and changing their size.
Patients with rubella often feel enlarged lymph nodes in the base of the skull, the back of the head, and behind the ears. They are big enough to be localized with the hands, but not big enough to create a deformity in the contour of the face. In rubella, enlarged lymph nodes are often tender and mobile, and do not feel solid.
Lymph nodes are common in many different diseases, both viral and bacterial, and they often appear near the site of the infection. However, if we find lymph nodes in different parts of the body, often distant from each other, it might be indicative that the infection is not located in a single area of the body and might be a blood-borne or systemic infection.