Smallpox differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Prior to its eradication, smallpox would need to be differentiated from other diseases similarly presenting with a vesicular rash and fever, such as chickenpox, herpes zoster and erythema multiforme.
Differentiating Smallpox from other Diseases
- Insect bites - In an insect bite, the insect injects formic acid, which can cause an immediate skin reaction often resulting in a rash and swelling in the injured area, often with formation of vesicles.
- Kawasaki disease - commonly presents with high and persistent fever, red mucous membranes in mouth, "strawberry tongue", swollen lymph nodes and skin rash in early disease, with peeling off of the skin of the hands, feet and genital area.
- Measles - commonly presents with high fever, coryza and conjunctivitis, with observation of oral mucosal lesions (Koplik's spots), followed by widespread skin rash.
- Atypical measles
- Acute leukemia
- Secondary syphilis
- Infectious mononucleosis
- Toxic erythema
- Drug eruptions