fever & rash

Etiology: 1) centrally distributed maculopapular eruption a) viral exanthems - rubeola (measles) - rubella (German measles) - erythema infectiosum (parvovirus B19) - exanthem subitum (roseola, human herpesvirus-6) - primary HIV infection - infectious mononucleosis - echovirus 2, 4, 9, 11, 16, 19, 25 - coxsackievirus A9, B1, B5 b) bacterial exanthems - epidemic typhus (Rickettsia prowazekii) - endemic (murine) typhus (Rickettsia typhi) - scrub typhus (Rickettsia tsutsugamushi) - Rickettsial spotted fevers - ehrlichiosis (Ehrlichia species) - leptospirosis (Leptospira interrogans) - Lyme disease (Borrelia burgdorferi) - typhoid fever (Salmonella typhi) - rat-bite fever (soduka, Spirillum minus) - relapsing fever (Borrelia species) - erythema marginatum (rheumatic fever, Group A strep) c) autoimmune disease - systemic lupus erythematosus - Still's disease (adult onset) 2) peripheral eruption a) viral exanthems - atypical measles (paramyxovirus) - hand-foot & mouth-disease (Coxsackievirus A16) b) bacterial exanthems - chronic meningiococcemia (Neisseria meningitidis) - disseminated gonococcal infection (Neisseria gonorrhoeae) - Rocky Mountain spotted fever (Rickettsia rickettsii) - secondary syphilis (Treponema pallidum) - Haverhill fever (Streptobacillus moniliformis) - bacterial endocarditis (Streptococcus, Staphylococcus) c) erythema multiforme 3) confluent desquamative erythema a) bacterial exanthems - scarlet fever (Group A strep) - toxic shock syndrome (Group A strep, S. aureus) - Staphylococcal scalded-skin syndrome b) Kawasaki disease c) exfoliative erythroderma syndrome d) toxic epidermal necrolysis 4) vesiculobullous eruption a) viral exanthems - hand-foot & mouth-disease (Coxsackievirus A16) - chickenpox (Varicella zoster) b) bacterial exanthems - Staphylococcal scalded-skin syndrome - rickettsialpox (Rickettsia akari) - Vibrio vulnificus c) toxic epidermal necrolysis d) echthyma gangrenosum (gram-negative rods, fungi) 5) urticarial eruption - urticarial vasculitis - serum sickness - connective tissue disease - infection - idiopathic 6) nodular eruption - disseminated infection (fungal, mycobacterial) - erythema nodosum (infections, drugs, sarcoidosis) - Sweet's syndrome (Yersinia, lymphoproliferative disorder) 7) purpuric eruption a) viral exanthems - enteroviral petechial rash - echovirus 9 - coxsackievirus A9 - viral hemorrhagic fever (arbovirus, arenavirus) b) bacterial exanthems - acute meningiococcemia (Neisseria meningitidis) - chronic meningiococcemia (Neisseria meningitidis) - disseminated gonococcal infection (Neisseria gonorrhoeae) c) thrombotic thrombocytopenic purpura (TTP) d) purpura fulminans (severe DIC)

General

fever rash

References

Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 91-96