Differential diagnosis of fever with rash

Sudden onset of high fever without rash or other symptoms in a child younger than 3 years; as fever subsides, pink, discrete, 2- to 3-mm blanching macules and papules suddenly appear on trunk and. It must be emphasized that non-infectious diseases with skin rash can also present with fever and should be considered in the differential diagnosis. Drug adverse reactions occur in approximately 5% of patients. The rate of cutaneous reactions is highest for antibiotics (1-8%) General Presentation. Children frequently present at the physician's office or emergency room with a fever and rash. Although the differential diagnosis is very broad, adequate history and physical examination can help the clinician narrow down a list of more probable etiologies. It is important for physicians to be diligent, as the differential. Signs/Symptoms Associated with Rash • Fever duration and characteristics • Signs of shock - Hypotension, poor perfusion, decreased consciousness • Irritability • Headache • Respiratory symptoms • Eye changes • Mucous membrane lesions or pain • Joint pain or swellin

The Generalized Rash: Part I

DIFFERENTIAL DIAGNOSIS OF FEVER WITH RASH LESION PATHOGENS OR INFECTION a) Maculopapular rash: central distribution VRS - Measles, rubella, roseola, erythema infectiosum, EBV, echovirus, HBV, HIV BACT - Erythema marginatum, scarlet fever, erysipelas, 2° syphilis, leptospirosis, Lyme dzs, RICK - Rocky Mountain Spotted fever, Typhus OTH - RA, Kawasaki dis, drug rx differential diagnosis of fever with rash 9. CASE SCENARIO History: 9 mo old girl, good general health condition Progressive fever for 5 days (max. 39.50C) Coryza, exudative conjunctivitis Severe cough and irritability No diarrhea, no vomiting No recent travel, no pets Rashes - over trunk, abdomen and back - appear 4 days after onset of fever - not elevated and no itching - blanching on pressur The evaluation of rashes in the febrile pediatric patient includes a broad differential diagnosis and use of the history and physical examination to identify red flags, such as hemodynamic instability, erythroderma, desquamation, petechiae/purpura, mucous membrane involvement, and severe pain, that should increase suspicion for worrisome disease The triad of fever, rash, and arthritis in a hospitalized child suggests an inflammatory, infectious, or postinfectious process in most cases.

Fever and Rash - Infectious Disease Adviso

Cream poster with black lettering. Title and caption at top of poster. Poster features six illustrations of children with diseases involving rashes, along with explanations of the diseases and close-ups of helpful diagnostic features. Diseases include measles, rubella, chickenpox, roseola, scarlet fever, and fifth disease Fever; Weakness; Syncope; Altered Mental Status; Seizure; Dizziness and Vertigo; Headache; Sore Throat; Dyspnea; Chest Pain; Abdominal Pain; Nausea and Vomiting; Gastrointestinal Bleeding; Acute Pelvic Pain; Back Pai Fever accompanied by rash is a common finding in pediatric patients. Although, in most cases, the disease is trivial, in some cases it may be the first and/or the sole manifestation of a serious and life- threatening condition in patients. The spectrum of differential diagnosis is broad an Fever and rash is a relatively common presentation in travellers returning from the tropics. The presence of a rash as part of a febrile illness, although rarely pathognomonic, focuses the differential diagnosis. It is important to remember that rashes are common and can be caused by medical conditions or drug reactions unrelated to travel Fever in a neonate is a fever without localizing signs in a neonate usually < 28 days but some people extend the timing to < 3 months of age. Learning Point The differential diagnosis of fever includes: Allergic Drug reaction - malignant hyperthermia Vaccine reaction Serum sickness Dermatologic Ectodermal dysplasia Immunologi

Approach to a the Child with a Fever and Rash Learn

  1. Differential Diagnosis of Dengue with Rash Illness History Exam Tests Scarlet Fever (Group A beta-hemolytic streptococcus infection) • Occurs most commonly in children, 1-10 years, during the nonsummer months • Family gives history of abrupt onset of fever, sore throat, headache, malaise, and vomiting, 2-5 days post exposur
  2. Differential Diagnoses. Arenaviruses. Chikungunya Virus. Ebola Virus Infection. Hemorrhagic Fever Viruses. Immune Thrombocytopenia (ITP) in Emergency Medicine. Influenza. Leptospirosis. Malaria. Mayaro Fever. Meningitis. Orbivirus. Rickettsial Infection. River Virus. Rocky Mountain Spotted Fever (RMSF) Roseola Infantum. Ross River Fever. Scarlet Fever. Sinbis Virus. Typhu
  3. e a diagnosis, although it has limited value in comparison to more specific laboratory tests. Differential diagnosis of fever by cours
  4. Differential Diagnosis of Dengue with Rash fever, headache, runny nose, and rash. Patient might complain of arthralgia. Fever, facial erythema or slapped cheek rash in first 1-4 days, followed by a generalized lacy rash that lasts 4-10 days and can be pruritic. Arthritis involving hands, feet or knees can be present, especially in.
  5. Differential Diagnosis (DD) of Febrile Diseases. Chapter. 1.8k Downloads. #x203A; Establishing a diagnosis from several clinical presentations is a common challenge in paediatrics that needs knowledge and experience to solve. This chapter provides clinicians with a guide to clinical and laboratory means to reach a diagnosis of the most common.
  6. al pain: Enteric fever, amebic or pyogenic liver abscess: Fever and normal or low white blood cell coun

The differential diagnosis of rash and arthritis is wide, but in most cases a diagnosis can be made on the basis of history, clinical examination, and appropriate blood tests. #### Differential diagnosis of rash and arthritis Several microorganisms can cause both a rash and arthritis, either by direct infection or by immune mediated mechanisms Rash - Wikipedia Approach to Patient with a Generalized Rash - NCBI - NIH The Generalized Rash: Part I. Differential Diagnosis - AAFP Papular Rash - an overview | ScienceDirect Topics Fever and Rash - Infectious Disease and Antimicrobial Agent

Video: Fever & Rash - SlideShar

2. fever with rash - SlideShar

  1. During a CHIK outbreak in a DVI-endemic area, overdiagnosis of CHIK was common. Skin rash during fever and white blood cell count ≥ 5000 cells/mm(3) or specific antigen testing (if available) can be helpful in differentiating CHIK from DVI
  2. Chickenpox or varicella might also be considered in this differential diagnosis. Fever and vesicular rash certainly could be caused by the varicella virus. The rash seen with chickenpox traditionally starts on the face and trunk and spreads peripherally. Varicella lesions progress through stages of papule, vesicle, pustule, rupture and crust
  3. The differential diagnosis of acute fever and rash in an adult is quite extensive and includes a variety of infectious and non-infectious causes. Infectious disease emergencies and diseases that can have public health implications can present as fever and rash
  4. ation. A systematic approach is crucial for establishing a timely diagnosis, deter

Differential diagnosis of fever with rash in Pediatrics

Target Audience and Goal Statement. This activity is intended for primary care clinicians, infectious disease specialists, and other clinicians caring for patients, particularly children, with fever, rash and other symptoms for which Rocky Mountain spotted fever and meningococcemia would be included in the differential Poster features six illustrations of children with diseases involving rashes, along with explanations of the diseases and close-ups of helpful diagnostic features. Diseases include measles, rubella, chickenpox, roseola, scarlet fever, and fifth disease. Allergic dermatitis is also addressed, though without any illustrations DIFFERENTIAL DIAGNOSIS. The patient is a 23-year-old woman with a subacute illness characterized by spiking fevers, sore throat, rash, polyarthritis, leukocytosis, elevated ESR and CRP level, abnormal liver function tests, and an elevated serum ferritin level. The differential diagnosis includes infectious, rheumatic, and neoplastic etiologies The patient with an acute maculopapular rash presents a diagnostic challenge to the clinician. The term 'maculopapular is non-specific, as many eruptions have a primary morphology of macules or papules, and the term may be misused to indicate any rash. The term 'rash' is also non-specific and is. Mnemonic: Very Sick Person Must Take Double Eggs. V aricella (Chicken pox): 1st day (rash is often 1st sign in children) S carlet fever: 2nd day. P ox (Small pox): 3rd day. M easles (Rubeola or 14 day measles): 4th day (Remember: Koplik spots appear in pre-eruptive phase on 2nd day of fever) T yphus: 5th day. D engue: 6th day

Search 4: Differential diagnosis of blanching macules, widespread distribution, arthralgias, and travel to Haiti (using VisualDx) For Patients: To understand the differential diagnostic process by using an age and body location diagnostic approach, try the Rash Skin Condition Finder. Part 5: Common and Serious Dermatologic Conditions Rash and fever are some of the most common chief complaints presenting in emergency medicine. The evaluation of skin rashes in the febrile pediatric patient includes a broad differential diagnosis and utilizing the signs and symptoms to identify red flags, such as hemodynamic instability, erythroderma, desquamation, petechiae/purpura, mucous membrane involvement, and severe pain, in the.

Differential diagnosis of rash illnesses - Digital

  1. Jan 24, 2020 Acute polyarthritis has a very wide differential diagnosis , presenting significant diagnostic difficulties. Oct 16, 2020 Scarlet fever is a bacterial illness that develops in some people who have strep throat. Aug 31, 2020 What is the differential diagnosis for polyarthralgia in a patient with a recent history of fever and rash
  2. Usually mild - fever, rash, conjunctivitis, muscle and join pain, headache and malaise . differential diagnosis in the context of an undifferentiated febrile illness particularly i
  3. Fever usually goes away once the illness passes. However, toddlers sometimes develop a rash following a fever. Although this is rarely severe, it is important to see a doctor immediately. Most common Causes and differential diagnosis : Roseola infantum; Roseola infantum, which is also called roseola or sixth disease, is a viral infection
  4. Blanching erythematous maculopapular rash that begins in the head and neck and spreads centrifugally, to trunk and extremities. Associated symptoms: fever, cough, coryza and conjunctivitis. Children with measles are usually quite sick. Look for buccal lesions: clustered, white lesions on the buccal mucosa, opposite the lower 1st and 2nd molars
  5. Differential Diagnosis of Maculopapular Rash. Maculopapular rash may be mistakenly called macule, papule, patch, nodule, plaque, vesicle, or pustule. To differentiate these skin lesions from each other, here are the pictures of each. Picture 12: Macule measures less than 1 cm. It is a flat blemish like that of a freckle

Differential Diagnosis of Feve

Differential Diagnosis A guide to the differential diagnosis of fever and a skin rash is given in Table 49-1; it includes treatable infectious disease emergencies (e.g., Rocky Mountain spotted fever, meningococcal or staphylococcal septicemia, and TSS) FEVER and RASH: MORE THAN MEETS the EYE Introduction RASH - May be hallmark of disease or nonspecific - An important clue to etiology of illness - Differential diagnosis is critical - Recognition is key to making a good diagnosis and instituting early and appropriate treatment and infection control . Beware of the chil Hemophagocytic lymphohistiocytosis may present with malaise, fatigue, erythematous skin rash, abdominal discomfort and pancytopenia. Acute myeloid leukemia or Acute lymphoblastic leukemia could present with a rapid onset of fatigue, shortness of breath, fever, rigors and pancytopenia. Differential diagnosis of pancytopenia in an adult If RMSF is treated with antibiotics aimed at another pathogen, the characteristic rash in RMSF may be mistaken for a drug eruption. Conditions to consider in the differential diagnosis of RMSF include the following: Meningitis. Meningococcemia. Q Fever. Rickettsialpox. Streptococcus group A infections. Streptococcus group B infections

Fever and rash - Medicin

  1. ation. Differential Diagnosis for Child with Fever: Acute Otitis Media. Scarlet fever. Sepsis. Gastroenteritis. Upper Respiratory Infection. Urinary Tract Infection. Meningitis
  2. The differential diagnosis of itchy skin — codes and concepts open Introduction. Itch is defined by a desire An acute or chronic itchy rash is most often due to dermatitis / eczema. Dermatitis can be primary, fever, heat, sunlight, hospitalisation, and medications
  3. imize morbidity and mortality. Emergency physicians have long been advised to approach the differential diagnosis of dermatologic conditions based on the appearance of skin lesions. 4 This descriptive approach is also effective for identification of critical rashes.
  4. This rash usually last 2-3 days. In addition petechiae and ecchymoses may also be present. A second measles-like (morbilliform) rash may appear within 1-2 days of defervescence (abatement of fever), this rash spares the palms and soles, and occasionally desquamates. 2. Critical (plasma leak) phase - riskiest time for developing complications
  5. Clinical characteristics of the rash and and serologic testing confirm the diagnosis. Other Differentials AIDS should be differentiated from other conditions presenting with fever , fatigue , weight loss , arthralgia , myalgia , rash and soft tissue swelling
  6. Well-appearing children without systemic symptoms or signs are unlikely to have a dangerous disorder. The appearance of the rash typically narrows the differential diagnosis. The associated symptoms and signs help identify patients with a serious disorder and often suggest the diagnosis (see Table: Some Causes of Rash in Infants and Children)
  7. Febrile seizures may accompany the rise in fever. Diagnosis. The clinical picture of a rash following a high fever in a well-appearing child is enough to seal the diagnosis. Confirmatory viral titers are seldom necessary or helpful. Other viral rashes, scarlatina, or drug eruptions are in the differential diagnosis. Pathogenesi

A laboratory‐confirmed diagnosis was achieved in 71.3% of cases: 33% were diagnosed with dengue fever, 20% with rubella, 9.2% with human parvovirus B19, 6.7% with measles, and 2.1% with HHV‐6. 4 These results underline the important proportion of cosmopolitan febrile exanthemas Differential diagnoses of urticaria include: Atopic eczema — lesions are usually accompanied by a greater degree of surrounding xerosis and erythema, and the rash typically lasts beyond 24 hours.For more information, see the CKS topic on Eczema - atopic. Contact dermatitis — eczematous rash, at any site related to a topical allergen, in a person of any age The diagnosis may confirm any number of conditions. The presence of a rash may aid diagnosis; associated signs and symptoms are diagnostic of certain diseases. For example, the rash in measles is an erythematous, morbilliform, maculopapular rash that begins a few days after the fever starts. It classically starts at the head, and spreads downwards The information on differential diagnosis of scarlet fever is based on expert opinion in the Public Health England (PHE) publication Guidelines for the public health management of scarlet fever outbreaks in schools, nurseries and other childcare settings [], and expert opinion in review articles on rashes [Ramsay, 2002; Watkins, 2008] and on scarlet fever [Holden, 2015; Basetti, 2017; DTB. with a generalized rash. •Develop a differential diagnosis of these rashes based on the systematic application of a series of qualifiers including: •salient patient history •the characteristics of the lesions •the location of these lesions •and the results of selective diagnostic tests

Patients with an erythematous rash plus fever are also at high risk for having a deadly diagnosis. Approach to the erythematous rash [2] Febrile & Positive Nikolsky's Sign: Patients in this group have the potential to be sick (Fever + Rash= Badness). But thy also have the potential to lose large amounts of skin which lead to fluid loss and. In addition, the introduction of additional laboratory methods for differential diagnosis is required for the final classification of suspected cases with maculopapular rash and fever in the.

What's in the Differential Diagnosis of Fever

The approach begins with a search for. Headache differential diagnosis chart. Pain above the knee cap yellow. This knee pain diagnosis chart focuses on pain at the front of the knee. Primary headaches eg tension migraine cluster primary headaches are headache syndromes not due to another cause. Irritation of the thick band on the outer leg Based on your differential diagnoses list, what focused PE would you perform? What labs or diagnostic tests, if any, would you order? o Diagnosis of type 2 diabetes can be made using fasting plasma glucose, A1C testing, random plasma glucose testing, or an oral glucose tolerance test (Pippitt & Gurgle, 2016). I would consider these tests Definite diagnosis. Based on table 11 SLE diagnostic criteria of the American College of Rheumatology revised in 1997, including: A butterfly-shaped rash on the face: fixed, flat or raised on the skin, spreading on both cheeks. Discoid rash: rounded on the surface of the skin, concave in the middle may be accompanied by atrophic scars

Assessment of rash in children - Differential diagnosis of

NR 511 FINAL EXAM 2 2020 with all the correct answersGraded A Janet is a 30 year old woman who has been recently diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspician of caudaequna compression. Which of the following is a sign or symptom of caudaequina compression? The patient has acute pancreatitis with 7 of the diagnostic criteria. Fever + Rash Two big picture points for thinking about ddx For some reason I always thought this ddx was short. It's super long and interesting! Organize ddx based on whether the patient is immunocompetent or immunocompromised and specifically whether they have HIV Ddx for immunocompetent patients (asterisks indicate life-threatening Can't miss diagnoses) Infectious Bacteria Patient Presentation A 19 month-old female comes to clinic with a 24 hour history of mild runny nose, fever to 101 degrees F and general tiredness. Late last night she kept saying 'owie' but her mother didn't know what was the problem. The child appeared to feel better after some acetaminophen and was okay ove Fever and rash in travellers returning from the tropics is a relatively common presentation, comprising around 4% of the febrile 'syndromes' presenting to travel or tropical diseases clinics. 1 The presence of a rash as part of a febrile illness, although rarely pathognomonic, focuses the differential diagnosis, although it is important not to forget that rashes are common and may be.

The patient presenting with fever and a rash presents a diagnostic challenge. While this syndrome suggests an infectious aetiology, the differential diagnosis remains broad, and requires a thorough history and physical examination to distinguish potential non-infectious causes. Epidemiological evidence is important in the differential diagnoses. The commonest febrile illnesses presenting with. Fever and rash is a relatively common presentation in travellers returning from the tropics, comprising around 4% of febrile 'syndromes' presenting to travel or tropical diseases clinics.1 The presence of a rash as part of a febrile illness, although rarely pathognomonic, focuses the differential diagnosis. It is importan Differential diagnosis of a palmar and plantar rash. A 35 year old man presented with a five day history of fever, cough, rash, and sore throat. He had conjunctivitis and a widespread maculopapular rash on his palms ⇑ and soles. The patient was pyrexial, tachycardic, and hypoxic on admission. Serology confirmed measles The rash with maculopapules and fever in adults Sonal Muzumdar, MD, Marti Jill Rothe, MD, Jane M. Grant-Kels, MD⁎ Dermatology Department, University of CT Health Center, Farmington, Connecticut, USA Abstract There is a broad differential diagnosis for the presentation of fever and maculopapular rash in an adult

Palmar rash - differential diagnosis, work up, treatment

The differential diagnosis are rashes caused by scarlet fever are triggered, and viral infections such as measles or rubella exclude triggered rashes. therapy The most important measure is the immediate discontinuation of the drug in question, possibly with the preparation of a drug from a different group of active ingredients, in order to Fever and Rash in Immunocompromised Patients Knowing the immune status of your patient is crucial since the differential diagnosis is expanded considerably in immunocompromised patients, and the suspicion for infectious causes is much higher (although these patients are often on multiple medications that can cause rashes) All children with fever and petechiae/purpura should be reviewed promptly by a senior clinician . History. Immunisation status - children <6 months of age or with incomplete immunisation status Rapid onset and/or rapid progression of symptoms and rash Pyrogens ‐ microbial products, microbial toxins (endotoxin), or whole microorganisms 2 General Presentation Children frequently present at the physician's office or emergency room with a fever and rash. Although the differential diagnosis is very broad, adequate history and physical examination can help the clinician narrow down a list of.

D. Diagnosis: Toxic shock syndrome should be considered in cases involving unexplained fever associated with an erythematous rash and diffuse organ involvement, especially in menstruating women. Diagnostic criteria include: Fever > 38.9°C < 90 mm Hg systolic pressure; Rash with subsequent desquamation (especially palms and soles The differential diagnosis for a teenager with fever, headache, arthralgias, and rash in the setting of a known animal bite is wide. This includes rabies, Rocky Mountain Spotted Fever (RMSF), ehrlichiosis, tularemia, and rat bite fever caused by either S moniliformis or Spirillum minus (Table 1) top on the list of differential diagnoses. Fever may occur along with this inflammation. Only the presence of fever would require frequent questioning, primarily to rule out infectious diseases, lymphoproliferative diseases, and malignancy. Skin and mucosa: Presence of specific skin lesions such as malar rash, vasculitis rash Postoperative fever is defined as a temperature higher than 38 C (or greater than 100.4 F) on two consecutive postoperative days or higher than 39 C (or greater than 102.2 F) on any postoperative day. Knowledge of differential diagnosis, as well as a systematic approach, proves useful in narrowing down the differential diagnosis and instituting proper management.[1][2

with fever and rash had a wide differential diagnosis. The most common type of rash was determined as maculo-papular, and the most frequent five diseases were measles, drug reactions, chickenpox, ASD and rickettsial infection. Viral diseases among infectious causes and drug reactions among noninfectious causes were determined as the leadin 17. Itchy skin - differential diagnosis 18. Leg ulcers: an overview 19. Molluscum contagiosum 20. Nail disorders 21. Perioral dermatitis 22. Photosensitive rashes (rashes made wo... 23. Pityriasis rosea 24. Pityriasis versicolor 25. Pruritus (itch) with no rash 26. Pruritis ani 27. Psoriasis 28. Rosacea 29. Scabies 30. Seborrhoeic eczema 31


Differential diagnosis of fever with rash - find out what

Differential Diagnosis I. Infectious mononucleosis. Rationale: Patients presenting with fever and swollen lymph glands with complaints of sore throat and recent fatigue provide rationale for this differential diagnosis. Infectious mononucleosis may begin slowly with fatigue, a general ill feeling, headache, and sore throat Given the extremely broad differential diagnosis, the presentation of a patient with fever and rash often poses a thorny diagnostic challenge for even the most astute and experienced clinician. Rapid narrowing of the differential by prompt recognition of a rash's key features can result in appropriate and sometimes life-saving therapy Meningococcal disease Short prodromal phase (fever, lethargy, malaise, nausea/vomiting), followed by the more specific and severe symptoms of meningitis and sepsis (limb pain, cold hands/feet, pale or mottled skin). Associated with non-blanching rash - a rapidly evolving petechial or purpuric rash is a sign of very severe disease Nosocomially acquired rashes have more limited differential diagnostic possibilities. 6 The clinician should determine whether the rash and fever represents the primary clinical problem or is a superimposed finding unrelated to another process—for example, ICU patients admitted for acute myocardial infarction can develop a drug rash from an.

Maculopapular Rash - Pictures, Causes, Treatment

Differential Diagnosis Rheumatic Feve

Petechial rash in children: a clinical dilemma: Why emergency nurses must be aware of the differential diagnoses associated with petechial rash before initiating treatment for invasive. Patients presenting with rash and fever have a broad differential diagnosis that includes relatively minor as well as life-threatening etiologies. A thorough history and physical examination and familiarity with common patterns of skin lesions and their potential causes will help the emergency physician make a quick diagnosis and accurate. Management of the Child with a Non-Blanching Rash Algorithm go straight to algorithm if patient unwell.. It is not uncommon for children to present to the Emergency Department with a non-blanching rash (accounting for approx. 2% of all attendances) +/- fever and other systemic features of illness. 1, 2 The minority of children with invasive bacterial infections, such as meningococcal disease. Bacterial and viral infections are frequently associated with a rash and fever in children. Many of these rashes have known etiologies and characteristic features. Recognizing the pattern of the rash, and identifying key points in the history can help to establish the diagnosis. In Table 27-1, a number of pediatric exanthems are summarized, as. NURS 6512 Week 4 Discussion Differential Diagnosis for Skin Conditions Properly identifying the cause and type of a patient's skin condition involves a process of elimination known as differential diagnosis. Using this process, a health professional can take a given set of physical abnormalities, vital signs, health assessment findings, and [

Measles differential diagnosis - wikidocErythema multiforme - Dermatologic IndicationsA teenager with fever, rash and arthritis | CMAJ

Non-blanching rashes are caused by small bleeds in the vessels beneath the skin, giving a purplish discolouration. Depending on the size of the individual lesions they can be defined as: Petechiae: <5mm diameter (figure 1). Purpura: 5-10mm diameter (figure 2). Ecchymoses: >1cm diameter (figure 3). Figure 1 Differential diagnosis for microscopic hematuria using isabel: Glomerulonephritis: This is often associated with fever and if the patient has had a recent infection like streptococcus. They may also experience nausea, vomiting, edema, sore throat, rash, arthralgia, dark urine. Cystitis: This is more common in women, and symptoms often increase. The diseases, which we may consider in the differential diagnosis with localized ACLE, are acne rosacea, contact dermatitis and photodermatitis, seborrheic dermatitis, dermatomyositis, erysipelas, and delusion of lupus.. 2.3.1. Acne rosacea vs ACLE. In its early stages, rosacea may present with a purely erythematous rash on the malar areas that can be very similar to ACLE Medical Intelligence Quiz. Challenge Yourself, Build Your Knowledge. Rash from scarlet fever. Question 1 of 5. The differential diagnosis for scarlet fever includes __________ in patients who clinically present with fever and rash. Choose one