Rash with fever resident survival guide

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rinky Agnes Botleroo, M.B.B.S.

Synonyms and keywords:

Overview

This section provides a short and straight to the point overview of the disease or symptom. The first sentence of the overview must contain the name of the disease.

Causes

Life Threatening Causes

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

• Meningococcemia or Meningoencephalitis
• Thrombotic Thrombocytopenic Purpura (TTP)
• Disseminated Intravascular Coagulation (DIC)
• Bacterial sepsis(Pneumococcal, Staphylococcal)

Common Causes

Common causes of rash with fever are given below :

• Typhoid fever
• Dengue hemorrhagic fever
• Rocky Mountain spotted fever (RMSF)
• Scarlet fever
• Toxic Epidermal Necrolysis (TEN)
• Stevens-Johnson Syndrome (SJS)
• Henoch-Schonlein Purpura (HSP)
• Kawasaki disease
• Lyme disease
• Endocarditis
• Disseminated gonococcal infection
• Autoimmune vasculitis
  • Systemic lupus erythematosus (SLE)
  • Rheumatoid arthritis
  • Sjogren’s syndrome
• Varicella
• Necrotizing fasciitis
• Hand foot and mouth (HFM) disease
• Anaphylaxis
• Shingles
• Rubella
• Measles

Diagnosis

Shown below are 04 algorithms summarizing the diagnosis of Rash with fever in a patient:

Patient with Fever and Rash

Take complete history

Record Vital signs: ❑ Measure the temperature ❑Record Pulse rate ❑Record Blood pressure ❑Record Respiratory rate

Ask about associated symptoms: ❑ Vomiting ❑ Nausea ❑ Abdominal Pain ❑ Cough ❑ Sore throat ❑ Chest pain ❑Arthralgias

Ask about other medical history: ❑ Asplenia ❑ Infection or Inflammation ❑Sarcoid ❑ Malignancy ❑ Collagen vascular disease ❑Any recent medications ❑Valvular heart disease ❑Chronic liver disease

Ask about recent travel history/Exposure: ❑Communal living ❑ Tick exposure ❑ Dog exposure ❑ Salt water exposure ❑ Tampon use ❑ International travel ❑ IVDU ❑Trauma and Diabetes Mellitus

Characterize rash

Maculopapular rash

Petechial/Purpuric rash

Vesiculobullous rash

Erythematous rash

Terminolgies used to diagnose Rashes

Term	Clinical Features
Lesion	Single,Small affected area
Rash	An eruption on the skin; more extensive than a single lesion
Macule	Well circumscribed area of change without elevation
Papule	Solid raised lesion ≤1 cm
Petechia	Small red/brown macule ≤1 cm that does not blanche
Purpura	Hemorrhagic area > 3 mm that does not blanch

Treatment

Shown below is an algorithm summarizing the treatment of [[disease name]] according the the [...] guidelines.

Do's

• The content in this section is in bullet points.

Don'ts

• Don’t use rubbing alcohol on skin
• Don't clean open wounds with hydrogen peroxide or bleach
• Don’t use a triple-antibiotic ointment