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Adult, Fever and Rash (Vesicles/Bullae (Infectious Bullae (Necrotic…

- - - - Varicella-Zoster Virus
        
        Complications: pneumonia, encephalitis, Reye's syndrome
        
        Different stages
      - HSV1&2
      - Variola (same stage)
    - - Vibrio vulnificus (bullous skin)
      - Pseudomonas
- - - - Measles (rubeola) :warning:
        
        fever, coryza, and mp rash (start in h&n spread centrally) Koplik's spots
      - Rubella
        
        fever, malaise, pst cervical lymphadenopathy + petechiae on soft palate
      - 5th disease (erthema infectiosum - Parvovirus B19)
        
        slapped-cheek appearance, recur with sun exposure, adult also present with arthritis and arthralgias
        
        Papular-purpuric gloves and socks syndrome (painful, puritic swelling of distal extremities) - adult
      - Cytomegalovirus (CMV)
        
        mononucleosis-type illness
      - Acute Human Immunodeficiency Virus Seroconversion
        
        fever, pharyngitis, lymphadenopathy and rash, malaise, myalgias, arthalgias (1-6 week after infection)
      - EBV (refer to petechia/purpura section
      - Human Herpesvirus-6 (HHV6) -> roseola or exanthem subitum
        
        mn-like illness + rsh after fever resolve / acute hepatitis
      - Enteroviruses mostly present with mp rash but some can present as petechial or vesicular rash / pharyngitis or diarrhea
        
        common cause of aseptc meningitis
      - Infectious mononucleosis
        
        associated with aminopenicillin admin (within 3 days)
    - - Syphilis via Treponema pallidum (2nd stage) - palms and sole rashes
      - RMSF can present as mp rash in early stage
      - Ehrlichiosis
        
        Human monoytotropic ehrlichiosis (HME) via Ehrlichia chaffeensis
        
        Human granulocytotropic anaplasmosis (HGA) via Anaplasma phagocytophilum (rash is rare)
      - Lyme disease via Borrela burgdorferi
      - Dengue can present as macular
      - Typhoid fever via Salmonella typhi
      - Meningococcemia :red_flag:
      - Staphylococcal scalded skin syndrome (SSSS)
      - Toxic Shock Syndrome (TSS) via Staph A. or GAS :red_flag: (Stanford's Big Four)
  - - - Toxic epidermal necrolysis >30% BA/
        Stevens-Johnson syndrome <10% BA :red_flag: (Stanford's Big Four)
        
        can cause by infections or cancer (rare)
        
        Allopurinol, antibiotics, antipsychotics, antiepileptics, and NSAID
      - Drug reaction with eosinophilia and systemic symptoms (DRESS)
    - - Acute graft-versus-host disease
      - Kawasaki diseases
      - Rheumatological disease
- - - - Rocky Mountain spotted fever by Rickettsia rickettssi via tick :red_flag: (Stanford's Big Four)
        
        Bite --with in one week-> fever + HEADACHE -> Rash after fever (may be intially maculopapular -> petechial)
        
        Spring/Summer
      - Acute Endocarditis (2nd to Staph. A)
        
        Heart disease/ IV drug use/ New or changing murmur
      - Neisseria meingitidis infection :red_flag: (Stanford's Big Four)
        
        Rapid progression and systemic toxicity.
        
        GDxg: blood culture
        
        Empirical antibioticif suspected meningococcemia (CSF)
        
        Purpura fulminans
    - - Epstein-Barr virus (EBV)
        
        mononucleosis type syndrome: pharyngitis, fever, malaise, adneopathy splenomegaly, and hepatitis
        
        Heterophile antibodies
      - Dengue
      - Life-threatening infection : :red_flag: Lassa fever virus, Ebola virus, Marburg virus, and Machupo virus
      - Asenteroviruses