Fever and rash

Petechial

• Infectious
  • Endocarditis
  • Meningococcemia
  • Gonococcemia
  • Gram negative bacteria
  • Enteric bacteria
  • RMSF
  • Enterovirus
  • Dengue Fever
  • Hepatitis B
  • Rubella
  • EBV
  • Rat bite fever
  • Epidemic typhus
• Noninfectious
  • Allergy
  • Thrombocytopenia
  • Scurvy
  • Lupus
  • HSP
  • Hypersensitivity vasculitis
  • Rhumatic fever
  • Amyloidosis

Pediatric

• Skin changes are often the most concerning finding in a pediatric fever

Differential

• Meningitis (Peds)
• HSP
• ITP
• Microangiopathic Hemolytic Anemia (MAHA)
• TTP
• HUS

Workup

• CBC
• Blood Cultures
• Basic Metabolic Panel (evaluating creatine)
• Chest Xray if pulmonary symptoms
• Lumbar Puncture depending on clinical findings and if not thrombocytopenic

Maculopapular

• Infectious
  • Typhoid fever/typhus
  • Secondary syphilis
  • Lyme
  • Meningococcemia
  • Mycoplasma
  • Psittacosis
  • Rickettsia
  • Leptospiroisis
  • Ehrlichiosis
  • Enterovirus
  • Parvovirus (B19)
  • 5th Dz
  • HSV 6
  • Rubeola
  • Rubella
  • Arbovirus
  • EBV
  • Adenovirus
  • Primary HIV
  • Streptobacillus moniliformis
• Noninfectious
  • Allergy
  • Serum Sickness
  • Erythema multiforme
  • Erythema marginatum
  • Lupus
  • Dermatomyositis
  • Sweet's syndrome
  • Acroderm enteropathica

Vesico-Bullous

• Infectious
  • Staph
  • GC
  • Rickettsia
  • HSV
  • Varicella
  • Vibrio vulnificans
  • Folliculitis (Staph, Candida, Pseudomonas)
  • Enterovirus
  • 5th Dz
  • Parvovirus B19
  • HIV
• Noninfectious
  • Allergy
  • Plant dermatitis
  • Eczema vaccinatum
  • Erythema multiforme bullosum

Erythematous

• Infectious
  • Staph/strep (toxic shock, scarlet fever)
  • Ehrlichiosis
  • Strep viridans
  • C. haemolyticum
  • Kawasaki's
  • Enterovirus
• Noninfectious
  • Allergy
  • Vasodilation
  • Eczema
  • Psoriasis
  • Lymphoma
  • Pityriasis rubra
  • Sezary syndrome

Urticarial

• Infectious
  • Mycoplasma
  • Lyme
  • Enterovirus
  • HIV
  • Hep B
  • Adenovirus
  • EBV
  • Strongyloides
  • Trichinosis
  • Schistosomiasis
  • Onchocerciasis
  • Loiasis
• Noninfectious
  • Allergy
  • Vasculitis
  • Malignancy
  • Idiopathic

See Also

• Rashes

References

• Tarascon Adult Emergency Pocketbook