ID Approach to Fever and Rash - Diagnostic Algorithm
Central Maculopapular (most common):
Measles, Parvovirus 819 / EBV, Acute HIV, WNV, Mycoplasma, Leptospirosis, Viral/Drug Exanthemas
Peripheral Maculopapular:
RMSF, Coxsackievirus A16 (HFMD), Parvovirus B19 (PPGSS), Secondary syphilis, EM (HSV, Mycoplasma), Infective endocarditis, Drug eruption
Confluent Desquamative:
Scarlet fever, TSS (Strep/Staph), SJS/TEN, DRESS, AGEP, Kawasaki, Erythroderma (psoriasis, drugs, lymphoma)
Vesiculobullous or Pustular:
SJS/TEN, HSV/VZV, Coxsackievirus A16 (HFMD), Pyoderma gangrenosum, Rickettsialpox, Disseminated gonococcal, Vibrio vulnificus, AGEP, Pustular Psoriasis
Purpuric:
RMSF, Neisseria meningitidis, Purpura fulminans, Viral hemorrhagic fevers, Parvovirus B19 (PPGSS), Vasculitis
Nodular:
Disseminated fungal, EN (drugs, Strep, mycobacterial, Yersinia), Bacillary angiomatosis, Sweet syndrome
Eschar:
Ecthyma (Pseudomonas, mold), Plague, anthrax, tularemia, Rickettsia akari (Rickettsialpox), Rickettsia conorii (Boutonneuse), Rickettsia africae (ATBF), Orientia tsutsugamushi (scrub), Spider bite
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