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|[[Rash with fever resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
|[[Rash with fever resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
|}
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{{CMG}}; {{AE}} [https://www.wikidoc.org/index.php/User:Lovepreet_Randhawa Lovepreet Randhawa]
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==Overview==
==Overview==
[[Rash]] with [[Fever]] in adults can be caused by [[allergic reactions]], [[Immune disorders]], [[infections]], etc.<ref name="pmid30981291">{{cite journal| author=Muzumdar S, Rothe MJ, Grant-Kels JM| title=The rash with maculopapules and fever in adults. | journal=Clin Dermatol | year= 2019 | volume= 37 | issue= 2 | pages= 109-118 | pmid=30981291 | doi=10.1016/j.clindermatol.2018.12.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30981291  }} </ref> <ref name="pmid23197907">{{cite journal| author=Tabak F, Murtezaoglu A, Tabak O, Ozaras R, Mete B, Kutlubay Z | display-authors=etal| title=Clinical features and etiology of adult patients with Fever and rash. | journal=Ann Dermatol | year= 2012 | volume= 24 | issue= 4 | pages= 420-5 | pmid=23197907 | doi=10.5021/ad.2012.24.4.420 | pmc=3505772 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23197907  }} </ref>. The infectious agents often trigger rash by mode of a [[toxin]] or an [[Immune reaction|immunogenic reaction]] to the [[antigens]]. Infectious agents associated with fever with rash in adults can be [[Viruses|viral]] or [[Bacteria|bacterial]]. Some examples of such organisms are the [[Rubeola]] virus, [[Staphylococcus aureus]], [[Borrelia burgdorferi]]. Among allergic reactions, drugs reactions are the ones most commonly associated with Rash with Fever. The clinical condition of the patient can range from mild flu-like symptoms in [[Lyme's disease]] to severe life-threatening situations such as [[Toxic shock syndrome]] caused by Staphylococcus aureus.  
 
[[Rash]] with [[Fever]] can occur in patients of all ages<ref name="pmid33187046">{{cite journal| author=Prakash N, Prakash J| title=Fever with Rash: A Clinical Dilemma. | journal=J Assoc Physicians India | year= 2020 | volume= 68 | issue= 11 | pages= 77-78 | pmid=33187046 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33187046  }} </ref>. [https://www.cdc.gov Centers for Disease Control and prevention(CDC)] defines a person to have a fever when "he or she has a measured temperature of 100.4° F (38° C) or greater, or feels warm to the touch, or gives a history of feeling feverish."  It is a common finding [[Fever and rash in children|in children]] as well as adults. In adults, it can occur due to multiple etiologies such as [[allergic reactions]], [[Immune disorders]], [[infections]], etc. <ref name="pmid30981291">{{cite journal| author=Muzumdar S, Rothe MJ, Grant-Kels JM| title=The rash with maculopapules and fever in adults. | journal=Clin Dermatol | year= 2019 | volume= 37 | issue= 2 | pages= 109-118 | pmid=30981291 | doi=10.1016/j.clindermatol.2018.12.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30981291  }} </ref> <ref name="pmid23197907">{{cite journal| author=Tabak F, Murtezaoglu A, Tabak O, Ozaras R, Mete B, Kutlubay Z | display-authors=etal| title=Clinical features and etiology of adult patients with Fever and rash. | journal=Ann Dermatol | year= 2012 | volume= 24 | issue= 4 | pages= 420-5 | pmid=23197907 | doi=10.5021/ad.2012.24.4.420 | pmc=3505772 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23197907  }} </ref>. The infectious agents often trigger rash by mode of a [[toxin]] or an [[Immune reaction|immunogenic reaction]] to the [[antigens]]. Infectious agents associated with fever with rash in adults can be [[Viruses|viral]] or [[Bacteria|bacterial]]. Some examples of such organisms are the [[Rubeola|Rubeola virus]], [[Staphylococcus aureus]], [[Borrelia burgdorferi]]. Among allergic reactions, adverse drugs reactions are the ones most commonly associated with Rash with Fever<ref name="pmid28515609">{{cite journal| author=Pannu AK, Adarsh MB, Sharma N| title=Not all febrile critical illness with rash is infective: Drug reaction may be a mimic. | journal=Indian J Crit Care Med | year= 2017 | volume= 21 | issue= 4 | pages= 229-231 | pmid=28515609 | doi=10.4103/ijccm.IJCCM_397_16 | pmc=5416792 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28515609  }} </ref>. The clinical condition of the patient can range from mild flu-like symptoms in [[Lyme's disease]] to severe life-threatening situations such as [[Toxic shock syndrome]] caused by Staphylococcus aureus<ref name="pmid33187046">{{cite journal| author=Prakash N, Prakash J| title=Fever with Rash: A Clinical Dilemma. | journal=J Assoc Physicians India | year= 2020 | volume= 68 | issue= 11 | pages= 77-78 | pmid=33187046 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33187046  }} </ref>.


==Causes==  
==Causes==  
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*[[Acute meningococcemia]] by [[Neisseria Meningitidis]]
*[[Acute meningococcemia]] by [[Neisseria Meningitidis]]
*[[Staphylococcal Scalded Skin Syndrome]] causes by [[Staphylococcus aureus]]
*[[Staphylococcal scalded skin syndrome|Staphylococcal Scalded Skin Syndrome]] causes by [[Staphylococcus aureus]]
*[[Toxic Epidermal Necrolysis|Toxic Epidermal Necrolysis-Steven Johnson syndrome]] (TEN-SJS)
*[[Toxic Epidermal Necrolysis|Toxic Epidermal Necrolysis-Steven Johnson syndrome]] (TEN-SJS)
*[[Toxic shock syndrome|Toxic Shock syndrome]] caused by Staphcocci or Streptococci
*[[Toxic shock syndrome|Toxic Shock syndrome]] caused by [[Staphylococci]] or [[Streptococcus|Streptococci]]
 




===Common causes===
===Common causes===


*Adult-onset Stills disease
*[[Adult-onset Still's disease|Adult-onset Stills disease]]
*Drugs reactions
*[[Adverse drug reactions|Drugs reactions]]<ref name="pmid28954636">{{cite journal| author=Ros MM, Delsing CE| title=[A woman with fever and a rash]. | journal=Ned Tijdschr Geneeskd | year= 2017 | volume= 161 | issue=  | pages= D1118 | pmid=28954636 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28954636  }} </ref>
*[[Infectious Mononucleosis]]
*[[Infectious Mononucleosis]]
*[[Measles|Measles/ Rubeola]]
*[[Measles|Measles/ Rubeola]]
*Rickettsial infections such as [[Lyme disease]], [[Rocky Mountain spotted fever]]
*Rickettsial infections<ref name="pmid32352736">{{cite journal| author=Pace EJ, O'Reilly M| title=Tickborne Diseases: Diagnosis and Management. | journal=Am Fam Physician | year= 2020 | volume= 101 | issue= 9 | pages= 530-540 | pmid=32352736 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32352736  }} </ref> such as [[Lyme disease]], [[Rocky Mountain spotted fever]]
*[[Systemic Lupus Erythematosus (SLE)|Systemic Lupus Erythematosus]]
*[[Systemic Lupus Erythematosus (SLE)|Systemic Lupus Erythematosus]]
*[[West Nile Fever]]
*[[West Nile Fever]]


<br />
===Less common causes===
===Less common causes===


*[[Dengue fever]]
*[[COVID-19]](SARS CoV-2)<ref name="pmid32330336">{{cite journal| author=Amatore F, Macagno N, Mailhe M, Demarez B, Gaudy-Marqueste C, Grob JJ | display-authors=etal| title=SARS-CoV-2 infection presenting as a febrile rash. | journal=J Eur Acad Dermatol Venereol | year= 2020 | volume= 34 | issue= 7 | pages= e304-e306 | pmid=32330336 | doi=10.1111/jdv.16528 | pmc=7267606 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32330336  }} </ref>
*[[Dengue fever]]<ref name="pmid33281008">{{cite journal| author=Pastor Bandeira I, Sordi Chara B, Meneguzzi de Carvalho G, Magno Gonçalves MV| title=Diffuse skin rash in tropical areas: Dengue fever or COVID-19? | journal=An Bras Dermatol | year= 2020 | volume=  | issue=  | pages=  | pmid=33281008 | doi=10.1016/j.abd.2020.10.001 | pmc=7670906 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33281008  }} </ref>
*[[Dermatomyositis]]
*[[Dermatomyositis]]
*[[Graft vs Host reaction]]
*[[Graft-versus-host disease|Graft vs Host reaction]]
*[[HIV AIDS|Acute HIV infection]]
*[[HIV AIDS|Acute HIV infection]]<ref name="pmid27929236">{{cite journal| author=Konheim A, Watts PJ, Tacastacas JD| title=Fever and Rash in a Patient with HIV Infection. | journal=Am Fam Physician | year= 2016 | volume= 94 | issue= 8 | pages= 658-660 | pmid=27929236 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27929236  }} </ref>
*[[Parvovirus B19]]
*[[Parvovirus B19]]
*[[Pyoderma gangrenosum]]
*[[Pyoderma gangrenosum]]
*[[Sweet's syndrome|Sweet Syndrome]]
*[[Sweet's syndrome|Sweet Syndrome]]
*[[Typhoid fever]]
*[[Typhoid fever]]
*[[Syphilis]]<ref name="pmid26219059">{{cite journal| author=Clement ME, Okeke NL, Hicks CB| title=Fever and Rash in a Patient With Hepatitis. | journal=JAMA | year= 2015 | volume= 314 | issue= 4 | pages= 400-1 | pmid=26219059 | doi=10.1001/jama.2015.3401 | pmc=6612369 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26219059  }} </ref>
<br />


===Causes by Organ system===
===Causes by Organ system===
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===Causes in Alphabetical Order<ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref><ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>===
===Causes in Alphabetical Order<ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref><ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>===


*[[Borrelia Burgdorferi]]
*[[Borrelia burgdorferi|Borrelia Burgdorferi]]
*[[Drug reaction]]s
*[[Drug reaction]]s
*[[Fifth disease]]
*[[Fifth disease]]

Latest revision as of 13:44, 18 January 2021
Resident
Survival
Guide

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Lovepreet Randhawa

Overview

Rash with Fever can occur in patients of all ages[1]. Centers for Disease Control and prevention(CDC) defines a person to have a fever when "he or she has a measured temperature of 100.4° F (38° C) or greater, or feels warm to the touch, or gives a history of feeling feverish." It is a common finding in children as well as adults. In adults, it can occur due to multiple etiologies such as allergic reactions, Immune disorders, infections, etc. [2] [3]. The infectious agents often trigger rash by mode of a toxin or an immunogenic reaction to the antigens. Infectious agents associated with fever with rash in adults can be viral or bacterial. Some examples of such organisms are the Rubeola virus, Staphylococcus aureus, Borrelia burgdorferi. Among allergic reactions, adverse drugs reactions are the ones most commonly associated with Rash with Fever[4]. The clinical condition of the patient can range from mild flu-like symptoms in Lyme's disease to severe life-threatening situations such as Toxic shock syndrome caused by Staphylococcus aureus[1].

Causes

Life threatening causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.


Common causes


Less common causes


Causes by Organ system

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Toxic Epidermal Necrolysis; Drug eruptions; Steven Johnson syndrome
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic No underlying causes
Hematologic Lymphoma
Iatrogenic No underlying causes
Infectious Disease Various viral and bacterial agents eg Zika, Dengue, Roseola, Typhoid, Parvovirus B19, Meningococci, Staphylococci
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic Paraneoplastic syndrome
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy SLE; Adult-Onset Still's disease; Dermatomyositis
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous No underlying causes


Causes in Alphabetical Order[11][12]

References

  1. ↑ 1.0 1.1 Prakash N, Prakash J (2020). "Fever with Rash: A Clinical Dilemma". J Assoc Physicians India. 68 (11): 77–78. PMID 33187046 Check |pmid= value (help).
  2. ↑ Muzumdar S, Rothe MJ, Grant-Kels JM (2019). "The rash with maculopapules and fever in adults". Clin Dermatol. 37 (2): 109–118. doi:10.1016/j.clindermatol.2018.12.004. PMID 30981291.
  3. ↑ Tabak F, Murtezaoglu A, Tabak O, Ozaras R, Mete B, Kutlubay Z; et al. (2012). "Clinical features and etiology of adult patients with Fever and rash". Ann Dermatol. 24 (4): 420–5. doi:10.5021/ad.2012.24.4.420. PMC 3505772. PMID 23197907.
  4. ↑ Pannu AK, Adarsh MB, Sharma N (2017). "Not all febrile critical illness with rash is infective: Drug reaction may be a mimic". Indian J Crit Care Med. 21 (4): 229–231. doi:10.4103/ijccm.IJCCM_397_16. PMC 5416792. PMID 28515609.
  5. ↑ Ros MM, Delsing CE (2017). "[A woman with fever and a rash]". Ned Tijdschr Geneeskd. 161: D1118. PMID 28954636.
  6. ↑ Pace EJ, O'Reilly M (2020). "Tickborne Diseases: Diagnosis and Management". Am Fam Physician. 101 (9): 530–540. PMID 32352736 Check |pmid= value (help).
  7. ↑ Amatore F, Macagno N, Mailhe M, Demarez B, Gaudy-Marqueste C, Grob JJ; et al. (2020). "SARS-CoV-2 infection presenting as a febrile rash". J Eur Acad Dermatol Venereol. 34 (7): e304–e306. doi:10.1111/jdv.16528. PMC 7267606 Check |pmc= value (help). PMID 32330336 Check |pmid= value (help).
  8. ↑ Pastor Bandeira I, Sordi Chara B, Meneguzzi de Carvalho G, Magno Gonçalves MV (2020). "Diffuse skin rash in tropical areas: Dengue fever or COVID-19?". An Bras Dermatol. doi:10.1016/j.abd.2020.10.001. PMC 7670906 Check |pmc= value (help). PMID 33281008 Check |pmid= value (help).
  9. ↑ Konheim A, Watts PJ, Tacastacas JD (2016). "Fever and Rash in a Patient with HIV Infection". Am Fam Physician. 94 (8): 658–660. PMID 27929236.
  10. ↑ Clement ME, Okeke NL, Hicks CB (2015). "Fever and Rash in a Patient With Hepatitis". JAMA. 314 (4): 400–1. doi:10.1001/jama.2015.3401. PMC 6612369 Check |pmc= value (help). PMID 26219059.
  11. ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  12. ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X


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