Differential Diagnosis of Fever & Rash








MACULAR OR MACULOPAPULAR RASH
Viruses Adenovirus

Measles

Rubella

Roseola (HHV-6 or HHV-7)

Erythema infectiosum (fifth disease, parvovirus B19)

Epstein-Barr virus

Echoviruses

HBV (papular acrodermatitis or Gianotti-Crosti syndrome)

HIV
Bacteria Erythema marginatum (rheumatic fever)

Scarlet fever (group A streptococcus)

Erysipelas (group A streptococcus)

Arcanobacterium haemolyticum

Secondary syphilis

Leptospirosis

Pseudomonas

Meningococcal infection (early)

Salmonella typhi (typhoid fever)

Lyme disease (erythema migrans)

Mycoplasma pneumoniae
Rickettsiae Rocky Mountain spotted fever (early)

Typhus (scrub, endemic)

Ehrlichiosis
Other Kawasaki disease

Rheumatoid arthritis

Drug reaction
DIFFUSE ERYTHRODERMA
Bacteria Scarlet fever (group A streptococcus)

Staphylococcal scalded skin syndrome

Toxic shock syndrome (Staphylococcus aureus)
Fungi Candida albicans
Other Kawasaki syndrome
URTICARIAL RASH
Viruses Epstein-Barr virus

HBV

HIV
Bacteria M. pneumoniae

Group A streptococcus
Other Drug reaction
VESICULAR, BULLOUS, PUSTULAR
Viruses Herpes simplex viruses

Varicella-zoster virus

Coxsackievirus
Bacteria Staphylococcal scalded skin syndrome

Staphylococcal bullous impetigo

Group A streptococcal crusted impetigo
Rickettsiae Rickettsialpox
Other Toxic epidermal necrolysis

Erythema multiforme (Stevens-Johnson syndrome)
PETECHIAL-PURPURIC
Viruses Adenovirus

Atypical measles

Congenital rubella

Congenital cytomegalovirus

Enterovirus

Papular-purpuric gloves and socks (parvovirus B19)

HIV

Hemorrhagic fever viruses
Bacteria Sepsis (meningococcal, gonococcal, pneumococcal, Haemophilus influenzae type b)

Infective endocarditis

Ecthyma gangrenosum (Pseudomonas aeruginosa)
Rickettsiae Rocky Mountain spotted fever

Epidemic typhus

Ehrlichiosis
Fungi Necrotic eschar (Aspergillus, Mucor)
Other Vasculitis

Thrombocytopenia

Henoch-Schönlein purpura

Malaria
ERYTHEMA NODOSUM
Viruses Epstein-Barr virus

HBV
Bacteria Group A streptococcus

Mycobacterium tuberculosis

Yersinia

Cat-scratch disease (Bartonella henselae)
Fungi Coccidioidomycosis

Histoplasmosis
Other Sarcoidosis

Inflammatory bowel disease

Estrogen-containing oral contraceptives

Systemic lupus erythematosus

Behçet disease

References:
Nelson Essential Pediatrics 6th Edition
 

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