Rash with fever

Rash with fever

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Differential diagnosis of causes of a rash and fever

In alphabetical order

• 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

References

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