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Cutaneous Conditions in Febrile Patients

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Cutaneous Conditions in Febrile Patients, Dermatologic Manifestations in Patients with Fever, Rash in the Febrile Patient, Febrile Patient with Rash, Fever and Rash, Febrile Eruption, Viral Exanthem, Diffuse Erythema and Desquamation in the Febrile Patient, Vesiculobullous Eruptions in the Febrile Patient, Petechial Eruptions in the Febrile Patient, Nodular Eruptions in the Febrile Patient, Centripetal Rash

  • Causes
  • Classic Exanthems (historical order of first identified)
  1. First: Rubeola (Measles)
  2. Second: Scarlet Fever (Streptococcus Pyogenes)
  3. Third: Rubella (German Measles)
  4. Fourth: Dukes' Disease (Coxsackievirus or Echovirus)
  5. Fifth: Fifth Disease (Erythema Infectiosum, Parvovirus)
  6. Sixth: Exanthem Subitum (Roseola Infantum, HH6, HH7)
  • Causes
  • Distribution of Febrile Eruption
  1. Central Eruptions (starts with head and neck, trunk)
    1. Viral Exanthem
      1. Rubeola (Measles)
      2. Rubella
      3. Parvovirus B19 (Erythema Infectiosum)
      4. Roseola Infantum (HH6)
    2. Drug eruption
    3. Typhoid Fever
  2. Peripheral Eruptions (Centripetal Rash - starts on distal extremities)
    1. Erythema Multiforme
    2. Secondary Syphilis
    3. Meningococcemia
    4. Rocky Mountain Spotted Fever
    5. Dengue Fever
    6. Coxsachievirus
  • Causes
  • Petechial Eruptions in the Febrile Patient
  1. See Purpura (or Petechiae)
  2. Common and Urgent Causes
    1. Meningococcemia
    2. Rocky Mountain Spotted Fever
  3. Viral Causes
    1. Coxsackievirus A9
    2. Echovirus 9
    3. Epstein-Barr Virus
    4. Cytomegalovirus
    5. Atypical Measles
    6. Viral Hemorrhagic Fever
      1. Arbovirus Infection
      2. Arenavirus Infection
  4. Other Causes
    1. Disseminated Gonococcus
    2. Staphylococcemia
    3. Thrombotic Thrombocytopenic Purpura
  • Causes
  • Diffuse Erythema and Desquamation in the Febrile Patient
  1. See Desquamation
  2. Most Common
    1. Scarlet Fever
    2. Kawasaki's Disease
    3. Toxic Shock Syndrome
    4. Scalded Skin Syndrome
  3. Less Common
    1. Ehrlichiosis
    2. Streptococcus viridans bacteremia
    3. Enteroviral infection
    4. Toxic Epidermal Necrolysis
    5. Graft-versus-host reaction
    6. Erythroderma
    7. Generalized Pustular Psoriasis (von Zumbusch)
  • Causes
  • Vesiculobullous Eruptions in the Febrile Patient
  1. See Vesiculobullous Rash
  2. Common
    1. Varicella Zoster Virus (Chicken Pox)
    2. Herpes Zoster (Shingles)
    3. Hand Foot and Mouth Disease
  3. Less common
    1. Staphylococcal Bacteremia
    2. Gonococcemia
  4. Immunocompromised Patient Causes
    1. Disseminated Herpes Simplex Virus
    2. Vibrio vulnificus (seafood exposure)
    3. Rickettsia akari
  • Causes
  • Nodular Eruptions in the Febrile Patient
  1. See Nodular Lymphangitis
  2. See Subcutaneous Nodule
  3. Erythema Nodosum
  4. Disseminated fungal infection (Immunocompromised)
    1. Disseminated Candidiasis
    2. Cryptococcosis
    3. Blastomycosis
    4. Histoplasmosis
    5. Coccidioidomycosis
    6. Sporotrichosis
  5. Other rare causes
    1. Nocardia
    2. Pseudomonas
    3. Mycobacterium species