Differential Diagnosis for Hemorrhagic Rash with Fever
- Single most likely diagnosis
- Viral Hemorrhagic Fever (VHF): This is a likely diagnosis due to the combination of hemorrhagic rash and fever, which are hallmark symptoms of VHFs such as Ebola, Marburg, Lassa fever, and others. These diseases are caused by viruses and can present with severe bleeding, including a hemorrhagic rash.
- Other Likely diagnoses
- Meningococcemia: This condition, caused by Neisseria meningitidis, can present with a hemorrhagic rash (purpura) and fever, among other symptoms. It's a serious infection that requires prompt treatment.
- Rocky Mountain Spotted Fever (RMSF): Caused by Rickettsia rickettsii, RMSF is characterized by fever, headache, and a distinctive rash that can become hemorrhagic. It's transmitted by ticks and is more common in certain geographic areas.
- Dengue Fever: While not always hemorrhagic, severe cases of dengue fever can present with a hemorrhagic rash and significant bleeding. It's a mosquito-borne illness common in tropical and subtropical areas.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Septicemia: Bacterial septicemia, especially when caused by organisms like Staphylococcus aureus or Streptococcus pneumoniae, can lead to a hemorrhagic rash (petechiae or purpura) and fever. Prompt recognition and treatment are crucial.
- Thrombotic Thrombocytopenic Purpura (TTP): A rare blood disorder characterized by clotting in small blood vessels throughout the body, TTP can cause fever, thrombocytopenia, and a hemorrhagic rash. It's a medical emergency requiring immediate treatment.
- Disseminated Intravascular Coagulation (DIC): This condition involves both widespread clotting and bleeding in the vascular system and can be triggered by various causes, including infections and trauma. It may present with a hemorrhagic rash and fever, among other symptoms.
- Rare diagnoses
- Ehrlichiosis: A group of tick-borne bacterial diseases that can cause fever, headache, and sometimes a rash. While not typically hemorrhagic, in rare cases, it might present with such symptoms.
- Leptospirosis: Caused by bacteria of the genus Leptospira, this disease can lead to a wide range of symptoms, including fever and, in rare cases, a hemorrhagic rash, especially in its more severe form, Weil's disease.
- Hantavirus: Certain strains of hantavirus can cause hemorrhagic fever with renal syndrome (HFRS) or hantavirus pulmonary syndrome (HPS), both of which can present with fever and, in the case of HFRS, potentially a hemorrhagic rash.