Differential Diagnosis for Viral Rash on a Kid's Face
- Single Most Likely Diagnosis
- Fifth disease (Erythema Infectiosum): This is a common viral illness in children, characterized by a distinctive "slapped-cheek" rash on the face, which is often accompanied by mild fever and upper respiratory symptoms. The rash typically starts on the cheeks and can spread to other parts of the body.
- Other Likely Diagnoses
- Measles: Although vaccination has made measles less common, it still occurs, especially in areas with low vaccination rates. The rash in measles starts on the face and spreads downward, accompanied by fever, cough, runny nose, and conjunctivitis.
- Rubella (German Measles): Similar to measles, rubella is characterized by a rash that starts on the face and spreads to other parts of the body, along with fever and lymphadenopathy.
- Roseola: This viral illness typically affects young children and is marked by a high fever followed by a rash that can appear on the face and trunk after the fever resolves.
- Do Not Miss Diagnoses
- Meningococcemia: This is a severe bacterial infection that can cause a rash, often on the face, which can be mistaken for a viral exanthem. The rash in meningococcemia is typically petechial or purpuric and is accompanied by severe illness, including fever, headache, and neck stiffness.
- Rocky Mountain Spotted Fever (RMSF): Although less common, RMSF can present with a rash on the face, along with fever, headache, and sometimes abdominal pain. The rash typically appears a few days after the onset of fever.
- Rare Diagnoses
- Enterovirus 71 infection: This can cause a variety of symptoms, including rash, and is known for causing hand, foot, and mouth disease, but can also lead to more severe neurological complications.
- Kawasaki Disease: An acute febrile illness of childhood characterized by inflammation in the walls of medium-sized arteries throughout the body, which can present with a rash on the face, along with fever, conjunctivitis, and changes to the lips and oral cavity.