Rash with fever
| Rash with fever |
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Differential diagnosis of causes of a rash and fever
- Drug reactions
- Fifth disease
- Measles
- Meningococcemia
- Parvovirus
- Rocky Mountain Spotted Fever
- Rubella
- Staphylococcus aureus
- Toxic Shock Syndrome
- Varicella
- Viral exanthems
History and Symptoms
- Focused history is essential as fever w/ rash has many causes
- Determine toxicity
- A quick determination of RMSF and meningococcemia are important for immediate therapy
Laboratory Findings
- Labs include
- Bacterial cultures from any wounds
- Toxic patients - blood cultures
- Meningococcemia (suspected) - Lumbar puncture
- Antibody titers confirm RMSF
- Skin biopsy can determine vasculitis and detect rickettsial organisms in endothelium
- TSS - Wound cultures with growth of staph or strep
Treatment
The most important thing is to evaluate the most dangerous diagnosis, then use "watch and wait" for less serious symptoms
Pharmacotherapy
Acute Pharmacotherapies
- RMSF - Doxycycline
- Meningococcal - Ceftriaxone