Fever with Rash - Indian Academy of Pediatrics · Peripheral rash with fever Erythema multiforme...

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Fever with Rash

Transcript of Fever with Rash - Indian Academy of Pediatrics · Peripheral rash with fever Erythema multiforme...

Page 1: Fever with Rash - Indian Academy of Pediatrics · Peripheral rash with fever Erythema multiforme Secondary syphilis Hand foot and mouth disease Dengue – Both central and peripheral

Fever with Rash

Page 2: Fever with Rash - Indian Academy of Pediatrics · Peripheral rash with fever Erythema multiforme Secondary syphilis Hand foot and mouth disease Dengue – Both central and peripheral

Urticaria Purpura

Page 3: Fever with Rash - Indian Academy of Pediatrics · Peripheral rash with fever Erythema multiforme Secondary syphilis Hand foot and mouth disease Dengue – Both central and peripheral

Eschar near medial canthus

Page 4: Fever with Rash - Indian Academy of Pediatrics · Peripheral rash with fever Erythema multiforme Secondary syphilis Hand foot and mouth disease Dengue – Both central and peripheral

History

1. Prodromal Symptoms

2. Evolution of rash

3. Associated Symptoms

4. Exposure to Infections – Persons, insects, animals

5. Travel, time of year, drug exposure

Page 5: Fever with Rash - Indian Academy of Pediatrics · Peripheral rash with fever Erythema multiforme Secondary syphilis Hand foot and mouth disease Dengue – Both central and peripheral

Examinations

1. Nature of rash

2. Rash distribution – Exanthem and enanthem

3. Mucosal conjunctival lesion

4. Lymph node – Liver and spleen

5. Genital lesion and CNS involvement

6. Timing in relation to fever

Page 6: Fever with Rash - Indian Academy of Pediatrics · Peripheral rash with fever Erythema multiforme Secondary syphilis Hand foot and mouth disease Dengue – Both central and peripheral

Broadly they are classified as

• Centrally distributed maculopapular

• Peripheral

• Confluent desquamative erythema

• Vesiculobullous

• Urticaria

• Purpuric

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Centrally distributed maculopapular rashes

Common viral exanthem

Drug rash

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Measles

Maculopapular rash over face Enanthem: mucus membrane

Maculopapular rash over trunk Maculopapular rash over palm

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Rubella

Page 10: Fever with Rash - Indian Academy of Pediatrics · Peripheral rash with fever Erythema multiforme Secondary syphilis Hand foot and mouth disease Dengue – Both central and peripheral

Rubella Fever : Not high grade

Rash scattered

Fever disappears when rash appears

Occipital, epitrochlear lymph node appears

No significant coryza

Short duration

Relatively benign diseases

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Roseola

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Roseola infantum (HSV 6)

• Rash appears on 4th or 5th day• Fever resolves by crisis or subsides by lysis • Caused by HSV 6 • Called as “sixth disease”• May cause febrile seizures, encephalitis, aseptic meningitis

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Erythema infectiousum (Fifth disease)Parvo virus• Fever for 3-5 days • Rash on face

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Lacy reticular rash

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Drug rash

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Features Drug rash

Rhinnorhea /conjunctivitis

Uncommon

Itching Present

Enanthem Absent

Eosinophilia and raised IgE

Usually present

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Features of drug rash

Page 17: Fever with Rash - Indian Academy of Pediatrics · Peripheral rash with fever Erythema multiforme Secondary syphilis Hand foot and mouth disease Dengue – Both central and peripheral

Peripheral rash with feverErythema multiforme

Secondary syphilis

Hand foot and mouth disease

Dengue – Both central and peripheral

Hand foot and mouth disease

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Morbiliform rash

Dengue rash

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Dengue rash

Page 20: Fever with Rash - Indian Academy of Pediatrics · Peripheral rash with fever Erythema multiforme Secondary syphilis Hand foot and mouth disease Dengue – Both central and peripheral

Spotted Fever and Typhusbelongs to Rickettsial group

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Eschar near medial canthus and chest

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Spotted fever and typhus belongs to rickettsial group – they are not uncommon in our country as numerous reports are there

References

1. Mahajan SK. Scrub Typhus. J Assoc Physic India 2005;53:954-82. Singh P. Scrub Typhus, a case report: Military and regionalsignificance.

MJAFI 2004; 60: 89-90.3. Soman DW. Tsutsugamushi disease (scrub typhus) inBombay City

and suburbs J Indiana State Med Assoc1954;23:389-94.4. Menon RD, Padbidri VS, Gupta NP. Sero-epidemiologicalsurvey of

scrub typhus. J Hyg Epidemiol Microbiol Immunol.1978;22:306-11.5. Saxena VK. Chigger mite infestation of small mammals in aferal

biotope of a public park area of south Delhi. J CommunDis. 1989;21:360-4.

6. Sharma A, Mahajan S, Gupta ML, et al. Investigation of an Outbreak of Scrub Typhus in Himalayan Region of India. Jpn J Infect Dis 2005;58:208-10.

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Herpes Simplex Virus 2 closely related types – HSV1 and HSV2

• Type of infection :ü Primary infection – HSV seronegative, no preexisting

immunityü Non primary 1st infection – Already infected with one type

but first time infected with other type.ü Recurrent infection – virus from latent infection periodically

reactivate• Spread by direct contact between skin and mucous membrane

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Herpes labialis/cold sore (Primary)

Herpes labialis/cold sore (Recurrent)

Herpetic Gingivostomatitis

Herpangina

Genital herpes Whitlow

Herpes Simplex Infection

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Fever with diffuse erythema and desquamation

1. Scarlet fever

2. Kawasaki disease

3. Streptococcal toxic shock syndrome

4. Staphylococcal toxic shock syndrome

5. Staphylococcal scalded skin syndrome

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Scarlet fever

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Skin and mucous membrane manifestation of Kawasaki diseases

Page 29: Fever with Rash - Indian Academy of Pediatrics · Peripheral rash with fever Erythema multiforme Secondary syphilis Hand foot and mouth disease Dengue – Both central and peripheral

Skin and mucous membrane manifestation of Kawasaki diseases

Page 30: Fever with Rash - Indian Academy of Pediatrics · Peripheral rash with fever Erythema multiforme Secondary syphilis Hand foot and mouth disease Dengue – Both central and peripheral

Purpuric eruption with fever

Meningococcemia

Viral infection – Coxsackie A9, echo virus, EB virus

Atypical measles

Dengue hemorrhagic fever

Bacteremia

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Acute Meningococcemia

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Fever with Inflammation ofSubcutaneous tissue

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Erythema nodosum

Idiopathic

Infections

Beta hemolytic streptococciMycobacterium speciesHepatitis B and CFungal Infection

Medicines

Sulfonamides, Oral contraceptives

SLE

Sarcoidosis

Inflammatory bowel disease

Malignancy – lymphoma and leukemia

Causes of Erythema nodosum


Rash Without Fever

Rash Without Fever

Signs Daniel Podd RPA-C. Beau's lines Strawberry tongue Peripheral papular or punctate rash Sandpaper rash Pastia's lines.

Signs Daniel Podd RPA-C. Beau's lines Strawberry tongue Peripheral papular or punctate rash Sandpaper rash Pastia's lines.

IDENTIFYING DATA FV 6 months old Male Roman Catholic Filipino CHIEF COMPLAINT: Fever and rashes 6 months old Fever Rash.

IDENTIFYING DATA FV 6 months old Male Roman Catholic Filipino CHIEF COMPLAINT: Fever and rashes 6 months old Fever Rash.

FEVER and RASH Lan-fang Tang Dept. Pediatric Pulmonology Email: tanglanfangzju@163.cm Pediatrics.

FEVER and RASH Lan-fang Tang Dept. Pediatric Pulmonology Email: [email protected] Pediatrics.

Dengue Fever. INTRODUCTION Dengue fever (DF) is an acute febrile viral disease frequently presenting with headaches,bone, joint and muscular pains, rash.

Dengue Fever. INTRODUCTION Dengue fever (DF) is an acute febrile viral disease frequently presenting with headaches,bone, joint and muscular pains, rash.

A 3 year old girl presents with high fever,extensive skin rash,and conjuctival congestion.

A 3 year old girl presents with high fever,extensive skin rash,and conjuctival congestion.

SCREENING FOR HEPATIC & BILIARY DISEASErevivefitness.yolasite.com/resources/Screening_for_Hepatic_Biliary_Disease.pdf · Jaundice Dark urine Clay-colored stools ... Fever, rash, arthralgias,

SCREENING FOR HEPATIC & BILIARY DISEASErevivefitness.yolasite.com/resources/Screening_for_Hepatic_Biliary_Disease.pdf · Jaundice Dark urine Clay-colored stools ... Fever, rash, arthralgias,

10Lec-FEVER AND RASH More Than MEETS the Eye

10Lec-FEVER AND RASH More Than MEETS the Eye

jknselangor.moh.gov.myjknselangor.moh.gov.my/images/2019/virusmonkeypox.pdffour weeks. It is characterised by fever, myalgia, headache, lymphadenopathy and rash. The rash which is

jknselangor.moh.gov.myjknselangor.moh.gov.my/images/2019/virusmonkeypox.pdffour weeks. It is characterised by fever, myalgia, headache, lymphadenopathy and rash. The rash which is

Rash and Fever Is it just a viral illness?...•The rash is macular at first, starts on ankles and wrists and spreads. The rash will tend to become petechial and then purpuric. •This

Rash and Fever Is it just a viral illness?...•The rash is macular at first, starts on ankles and wrists and spreads. The rash will tend to become petechial and then purpuric. •This

Dengue Infection and Other Fever With Rash

Dengue Infection and Other Fever With Rash

rash, exanthem, approach to exanthem, maculopapular exanthem, Exanthem seminar, Fever and Rash, Approach to patient with maculopapular exanthem

rash, exanthem, approach to exanthem, maculopapular exanthem, Exanthem seminar, Fever and Rash, Approach to patient with maculopapular exanthem

WHO Informal Consultation on fever management in peripheral … · WHO Informal Consultation on fever management in peripheral health care settings Background for organising the meeting:

WHO Informal Consultation on fever management in peripheral … · WHO Informal Consultation on fever management in peripheral health care settings Background for organising the meeting:

Scanned by CamScanner - Bharati Vidyapeethmchsangli.bharatividyapeeth.edu/media/pdf/... · Fever — Approach to rash ( exanthematous fever) Approach to chest pain & palpitations

Scanned by CamScanner - Bharati Vidyapeethmchsangli.bharatividyapeeth.edu/media/pdf/... · Fever — Approach to rash ( exanthematous fever) Approach to chest pain & palpitations

Fever and Rash Dr. Orli Megged Infectious Diseases Unit Shaare Zedek Medical Center.

Fever and Rash Dr. Orli Megged Infectious Diseases Unit Shaare Zedek Medical Center.

FEVER and RASH: - Pediatric Infectious Disease Society of the

FEVER and RASH: - Pediatric Infectious Disease Society of the

Three patients with fever and rash after a stay in Morocco: infection with Rickettsia ... · 2017-01-12 · Three patients with fever and rash after a stay in Morocco: infection with

Three patients with fever and rash after a stay in Morocco: infection with Rickettsia ... · 2017-01-12 · Three patients with fever and rash after a stay in Morocco: infection with

2. fever with rash

2. fever with rash

 · adults, but seldom causes death. high fever severe headache pain behind the eyes lever Example of a skin rash due to dengue fever muscle and joint pains Skin rash nause and vomiting

 · adults, but seldom causes death. high fever severe headache pain behind the eyes lever Example of a skin rash due to dengue fever muscle and joint pains Skin rash nause and vomiting

Thrombocytopenia, fever, rash, hypotension · §Must consider Dengue, Malaria, Typhoid, RickettsialDiseases §Travel history helps guide diagnosis ... Hristov_Case_Vignette_Final

Thrombocytopenia, fever, rash, hypotension · §Must consider Dengue, Malaria, Typhoid, RickettsialDiseases §Travel history helps guide diagnosis ... Hristov_Case_Vignette_Final