Fever and Rash

Abstract Generalized rashes with fever are among the most frequent conditions seen by primary care physicians and are a common reason for patient visits to the emergency department and dermatologists. The majority of cases do not represent an immediate danger, but some patients may have a life-threatening diagnosis, and a prompt and accurate approach is warranted. Fever and rash diagnosis are frequently challenging. There is a wide variety of clinical presentations and etiologies. Infections are the most common causes, but drug reactions, immunologic and rheumatic diseases, allergens, and neoplasia can also show with fever and rash. Based on visual and tactile characteristics of the eruption, skin lesions are usually grouped in macules, papules, nodules, plaques, vesicles and bullae, pustules, purpura, ulcers, or eschars. Epidemiology and presentation of the patient with fever and rash vary, according to the category of the disease. A comprehensive history and physical examination are the cornerstones in establishing the diagnosis. The distribution and progression of the skin lesions, along with associated symptoms, recent exposures, vaccination status, travel history, pets and habits, occupational exposures, season of the year, drug ingestions, sun exposures, and history of allergies must be addressed. There is an increasing number of emerging infectious diseases that can present with fever and rash, and with climate change, migration, and a higher number of individuals traveling to tropical and exotic destinations, physicians will probably see more patients with this syndrome.