Fever and rash

DDx

Diffuse maculopapular rash

  • Viral exanthem: measles, rubella (German measles), erythema infectiosum ("slapped-cheek" disease), exanthem subitum (roseola), primary HIV infection, infectious mononucleosis, dengue
  • Other infection: typhoid fever, secondary syphilis, Lyme disease, leptospirosis, rat-bite fever, relapsing fever, ehrlichiosis, epidemic typhus, endemic typhus, scrub typhus, erythema marginatum (rheumatic fever)
  • Noninfectious: drug rash (with drug fever or unrelated infection), systemic lupus erythematosus, adult Still’s disease
Peripheral eruption
  • Meningococcemia or gonococcemia
  • Secondary syphilis
  • Rocky Mountain spotted fever
  • Erythema multiforme
  • Bacterial endocarditis
  • Hand, foot, and mouth disease
Desquamative erythema
  • Toxic shock syndrome (staphylococcal or streptococcal)
  • Scarlet fever
  • Kawasaki disease
  • Staphylococcal scalded skin syndrome
  • Exfoliative erythroderma syndrome (eg, underlying psoriasis, eczema, drug eruption)
  • Erythema multiforme major or toxic epidermal necrolysis
Vesicles or bullae
  • Varicella (chickenpox)
  • Staphylococcal scalded skin syndrome
  • Erythema multiforme major or toxic epidermal necrolysis
  • Hand, foot, and mouth disease
  • Rickettsialpox
  • Ecthyma gangrenosum (neutropenic, pseudomonal)
  • Disseminated Vibrio vulnificus (cirrhosis, seafood or seawater exposure)
Purpura or petechiae
  • Bacterial endocarditis
  • Meningococcemia or gonococcemia
  • Rocky Mountain spotted fever
  • Purpura fulminans (severe disseminated intravascular coagulation)
  • Thrombotic thrombocytopenic purpura
  • Other: epidemic typhus, rat-bite fever, enteroviral petechial rash, viral hemorrhagic fever
Other
  • Urticarial vasculitis (serum sickness, connective tissue disease, infection, idiopathic)
  • Nodules due to disseminated infection (eg, fungal), erythema nodosum, Sweet’s syndrome (acute febrile neutrophilic dermatosis)
  • Pustular psoriasis

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Last updated: December 1, 2014