What are the causes of fever with vesicles?

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Last updated: March 4, 2025View editorial policy

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Differential Diagnosis for Fever with Vesicles

  • Single most likely diagnosis
    • Varicella (Chickenpox): This is the most common cause of fever with vesicles, especially in children. The rash typically starts on the trunk and spreads to other parts of the body, and the vesicles are in different stages of healing.
  • Other Likely diagnoses
    • Herpes Zoster (Shingles): This condition is caused by the reactivation of the varicella-zoster virus and typically presents with a painful rash and vesicles in a dermatomal distribution.
    • Herpes Simplex Virus (HSV) infection: HSV can cause fever and vesicles, especially on the lips (cold sores) or genital area.
    • Hand, Foot, and Mouth Disease (HFMD): This is a common viral illness in children, characterized by fever, vesicles on the hands and feet, and ulcers in the mouth.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Rabies: Although rare, rabies can present with fever and vesicles or pustules at the site of the animal bite.
    • Secondary Syphilis: This condition can cause a rash with vesicles, although it is less common.
  • Rare diagnoses
    • Smallpox: Although eradicated, smallpox can be considered in the event of a bioterrorism attack, and it presents with fever and a characteristic rash with vesicles.
    • Monkeypox: This is a rare viral illness that can cause fever and a rash with vesicles, similar to smallpox.
    • Disseminated Herpes Simplex Virus infection: This is a rare but serious condition that can occur in immunocompromised individuals, presenting with fever and widespread vesicles.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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