What is the diagnosis for a patient presenting with fever and rash?

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Last updated: April 21, 2025View editorial policy

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Differential Diagnosis for Fever with Rash

  • Single most likely diagnosis
    • Viral exanthem (e.g., roseola, measles, chickenpox): This is often the most common cause of fever with rash in children and adults, characterized by a widespread rash and fever, with the specific virus determining the appearance and distribution of the rash.
  • Other Likely diagnoses
    • Bacterial infections (e.g., streptococcal pharyngitis, staphylococcal skin infections): These can cause fever and rash, often with additional symptoms like sore throat or localized skin lesions.
    • Allergic reactions (e.g., urticaria, drug rash): These can present with fever and rash, especially if the reaction is severe or involves a medication.
    • Insect-borne illnesses (e.g., Lyme disease, Rocky Mountain spotted fever): Depending on the geographic location and exposure history, these diseases can cause fever and rash.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Meningococcemia: A severe, life-threatening infection that can cause fever, rash, and rapidly progressing illness, requiring immediate medical attention.
    • Toxic shock syndrome: A condition caused by bacterial toxins, leading to fever, rash, and severe systemic symptoms, which is fatal if not promptly treated.
    • Rocky Mountain spotted fever: While listed under other likely diagnoses, it's crucial to not miss this due to its high mortality rate if not treated early.
  • Rare diagnoses
    • Kawasaki disease: An acute febrile illness of childhood characterized by fever, rash, and other specific criteria, which can lead to cardiac complications if not recognized and treated.
    • Erythema multiforme: A skin condition characterized by target lesions, often triggered by infections or medications, which can be severe and requires specific management.
    • Stevens-Johnson syndrome: A severe skin and mucous membrane disorder, usually a reaction to medication or infection, which can be life-threatening and requires immediate medical intervention.

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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