Fever with rash
Rizna KM
81
HAND ,FOOT AND MOUTH DISEASE
• Etiology –caused by enteroviruses
- most common : coxackievirus A16,enterovirus 71
- occurs mainly in children less than 5
• Clinical features -fever,sore throat,malaise ,rash on
hand and feet,painful oral ulcers
• Type of rash -vesicular rash,small erythematous
vesicles on palm,soles,buttocks,Painful oral vesicles
• Treatment:supportive care;antipyretics,fluids,mouth
care
ZIKA VIRUS INFECTION
• Etiology –zika virus
- transmitted by aedes mosquito
- also spread via sexual contact,blood transfusion,vertical
transmission
• Clinical features: mild fever,maculopapular rash,arthralgia,non-
purulent conjunctivitis,headache,myalgia
• Type of rash:diffuse maculopapular rash;
-starts on face n spreads to trunk and limbs,mildly pruritic
• Treatment:supportive(hydration,paracetamol)
INFECTIOUS MONONUCLEOSIS
• Etiology:Epstein-barr virus
-spread via saliva
• Clinical features:fever ,sore throat
- generalised lymphadenopathy,
- fatigue,
- splenomegaly,hepatomegaly
• Type of rash: generalized, non itchy maculopapular rash,classically
appears after ampicillin/amoxicillin
• Treatment: supportive care ,antipyretics
ADENOVIRUS INFECTION
• Etiology :adenovirus
- spread by respiratory droplets,
- fecal-oral route,contaminated water
• Clinical features: fever,URTI
- pharyngoconjuctival fever,
- conjunctivitis,
- diarrhoea,
- pneumonia
• Type of rash:,non-specific,generalized maculopapular rash
• Treatment:supportive care,cidofovir
bacterial
SCARLET FEVER
• Etiology: group A beta haemolytic streptococcus
-caused by erythrogenic toxin
• Clinical features:fever,
- sore throat, tonsilitis,
- strawberry tongue,
- cervical lymphadenopathy,
- circumoral pallor
• Type of rash: sandpaper-like erythematous rash,pastia’s lines
• Treatment: pencillin/amoxicillin
MENINGOCOCCEMIA
• Etiology:Neisseria meningitidis
- spread by respiratory droplets
• Clinical features :fever,
- toxic shock
-headache ,vomiting
• Type of rash: petechial/purpuric non –blanching rash, common on
trunk and lower limbs
• Treatment: IV antibiotic (ceftriaxone)
STAPHYLOCOCCAL INFECION
• Etiology:staphylococcus aureus
- spread via direct contact,fomites,or endogenous colonization
• Clinical features and type of rash:
- impetigo:vesicles-pustules-honey colored crusts
- scalded skin syndrome: widespread erythema ,blistering,skin peeling
- toxic skin syndrome:diffuse,erythematous,macular rash,desquamation of
palms/soles
• Treatment: MSSA: flucloxacillin/cephalexin
MRSA:vancomycin/linezolid
TYPHOID FEVER
• Etiology: salmonella typhi
- spread by feco-oral transmission
via contaminated food and water
• Clinical features: prolonged step ladder fever,
- headache ,
- malaise,abdominal pain,
- constipation(early),diarrhoe(late)
• Type of rash:Rose spots
- faint blanching maculopapular rash
- seen on trunk and abdomen,appears in 2nd week
• Treatment:antibiotics( ceftrixone,azithromycin,fluoroqiunolones)
DIPHTHERIA
• Etiology: corynbacterium diphtheriae
- produce diphtheria exotoxin
- spread by respiratory droplets
• Clinical features:fever,sore throat,greyish pseudomembrane over
tonsils/pharynx,dysphagia
• Type of rash:no characteristic rash,may have skin lesions in cutaneous diphtheria
• Treatment:antitoxin,
- antibiotics(erythromycin,pencillin)
- isolation of patient
- Supportive care
BRUCELLOSIS
• Etiology: brucella species
- melitensis,[Link],[Link])
- zoonotic infection
- transmission via unpasterized milk,dairy products,direct animal contact
• Clinical features: undulating fever,
- night sweating,
- fatigue,malaise,
- Arthralgia,myalgia
• Type of rash: rarely non-specific maculopapular rash
• Treatment: doxycycline+ rifampicin
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