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44 - Fever and Rash in the Pediatric Population

from Part II - Pediatrics

Published online by Cambridge University Press:  15 December 2009

By
Catherine A. Marco ,
Janel Kittredge-Sterling  and
Rachel L. Chin
Edited by
Rachel L. Chin
Catherine A. Marco
Affiliation:
Professor of Surgery Division of Emergency Medicine, University of Toledo College of Medicine, Toledo, OH
Janel Kittredge-Sterling
Affiliation:
St. Vincent Mercy Medical Center, Perrysburg, OH
Rachel L. Chin
Affiliation:
Editor in Chief, Professor of Emergency Medicine, University of California, San Francisco School of Medicine, San Francisco General Hospital, San Francisco, CA
Rachel L. Chin
Affiliation:
University of California, San Francisco
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Summary

INTRODUCTION

The combination of fever and rash is common in the pediatric population. Systemic etiologies, including meningococcal disease, rickettsial infections, viral infections such as measles and rubella, and drug hypersensitivity reactions are discussed in Chapter 4, Systemic Diseases Causing Fever and Rash. This chapter will discuss several additional etiologies specific to pediatric patients, including nonspecific viral exanthems, roseola infantum, erythema infectiosum, varicella-zoster infection, staphylococcal scalded skin syndrome, and Kawasaki disease.

A careful description of the timing of fever and appearance of skin lesions may be sufficient to narrow the diagnosis. Key elements of the history and physical are listed in Table 44.1.

EPIDEMIOLOGY

The large majority of cases of pediatric fever and rash, more than 70% in one study, are caused by viruses, and only approximately 20% are caused by bacteria. Viral exanthems are usually reactive and may be caused by enteroviruses, adenoviruses, echovirus, and numerous others. Infections with enteroviruses often peak in summer and autumn months.

Nonspecific Viral Exanthems

A variety of enteroviruses may cause a symptom complex including fever, malaise, gastrointestinal complaints, meningitis, and rash (Table 44.2). The enterovirus exanthem is typically maculopapular, although petechiae mimicking meningococcal infection may be seen. Petechiae have also been reported with coxsackievirus A9, echovirus 9, coxsackievirus A4, B2–5, and echovirus 3, 4, and 7 infections.

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Emergency Management of Infectious Diseases , pp. 265 - 272
Publisher: Cambridge University Press
Print publication year: 2008

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References

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  • Fever and Rash in the Pediatric Population
    • By Catherine A. Marco, Professor of Surgery Division of Emergency Medicine, University of Toledo College of Medicine, Toledo, OH, Janel Kittredge-Sterling, St. Vincent Mercy Medical Center, Perrysburg, OH, Rachel L. Chin, Editor in Chief, Professor of Emergency Medicine, University of California, San Francisco School of Medicine, San Francisco General Hospital, San Francisco, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.045
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  • Fever and Rash in the Pediatric Population
    • By Catherine A. Marco, Professor of Surgery Division of Emergency Medicine, University of Toledo College of Medicine, Toledo, OH, Janel Kittredge-Sterling, St. Vincent Mercy Medical Center, Perrysburg, OH, Rachel L. Chin, Editor in Chief, Professor of Emergency Medicine, University of California, San Francisco School of Medicine, San Francisco General Hospital, San Francisco, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.045
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Fever and Rash in the Pediatric Population
    • By Catherine A. Marco, Professor of Surgery Division of Emergency Medicine, University of Toledo College of Medicine, Toledo, OH, Janel Kittredge-Sterling, St. Vincent Mercy Medical Center, Perrysburg, OH, Rachel L. Chin, Editor in Chief, Professor of Emergency Medicine, University of California, San Francisco School of Medicine, San Francisco General Hospital, San Francisco, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.045
Available formats
×