What causes a rash on the mouth in a patient with influenza (flu)?

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Last updated: February 11, 2025View editorial policy

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Differential Diagnosis for Flu Rash on Mouth

  • Single most likely diagnosis
    • Influenza with secondary bacterial infection (e.g., streptococcal pharyngitis): This is a common complication of influenza, where the flu virus predisposes the individual to secondary bacterial infections, which can cause a rash on the mouth.
  • Other Likely diagnoses
    • Hand, Foot, and Mouth Disease (HFMD): A viral illness characterized by a rash on the hands, feet, and mouth, often caused by coxsackievirus A or enterovirus 71.
    • Herpangina: A viral illness caused by coxsackievirus A, characterized by small, painful blisters on the roof of the mouth and the back of the throat.
    • Primary Herpes Simplex Virus (HSV) infection: HSV can cause a painful rash on the mouth, lips, and gums, especially in children.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Stevens-Johnson Syndrome (SJS): A rare but life-threatening condition characterized by a severe skin and mucous membrane reaction, often triggered by medications or infections.
    • Toxic Epidermal Necrolysis (TEN): A severe skin condition usually triggered by medications, which can cause widespread skin necrosis and detachment.
    • Kawasaki Disease: A rare condition that mainly affects children, characterized by fever, rash, and swollen lymph nodes, which can lead to serious cardiac complications if left untreated.
  • Rare diagnoses
    • Erythema Multiforme (EM): A rare skin condition characterized by target-shaped lesions, often triggered by infections or medications.
    • Pemphigus: A group of rare autoimmune diseases that cause blistering of the skin and mucous membranes.
    • Aphthous stomatitis: A rare condition characterized by recurrent, painful ulcers on the mouth and lips, which can be triggered by various factors, including infections and autoimmune disorders.

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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