Differential Diagnosis for Hand Foot and Mouth Rash on Body Only
- Single Most Likely Diagnosis
- Hand, Foot, and Mouth Disease (HFMD): This is the most likely diagnosis due to the characteristic rash distribution and the common occurrence of this viral illness, particularly in children. HFMD is caused by viruses such as Coxsackievirus A or Enterovirus 71.
- Other Likely Diagnoses
- Varicella (Chickenpox): Although it typically starts on the trunk, the rash can spread to the extremities, and in some cases, the distribution might resemble HFMD. The presence of fever and the evolution of the rash into vesicles are key distinguishing features.
- Eczema Herpeticum: A disseminated herpes simplex infection in patients with atopic dermatitis, which can present with a rash on the body and extremities. It's crucial to consider this in patients with a history of eczema.
- Impetigo: A bacterial skin infection that can cause a rash, which might be confused with HFMD, especially if the lesions are not typical or if there's a secondary bacterial infection.
- Do Not Miss Diagnoses
- Meningococcemia: A severe bacterial infection that can cause a rash, often with a more sudden onset and associated with systemic symptoms like fever, headache, and neck stiffness. The rash can be petechial or purpuric and may appear anywhere on the body.
- Rocky Mountain Spotted Fever (RMSF): A tick-borne illness that can present with a rash on the extremities, including the hands and feet, along with fever and headache. It's critical to consider this diagnosis in individuals who have been exposed to ticks.
- Rare Diagnoses
- Kawasaki Disease: An acute febrile illness of childhood characterized by inflammation in the walls of medium-sized arteries throughout the body, which can include a rash on the body and extremities. It's rare but important to consider due to the risk of cardiac complications.
- Enteroviral infections other than HFMD: Other enteroviruses can cause rashes and systemic illnesses, and while less common, they should be considered in the differential diagnosis, especially during outbreaks or in immunocompromised patients.