HEMORRHAGIC FEVERS (Fever with Petechiae/Purpura)
TABLE 10.5: D/D of rash in common exanthematous fevers
GEN: Generalized
1usual day of appearance of rash, may vary.
A simpler way to remember the day of appearance of rash is to remember a mnemonic - 'Very Sick Patient Must Take Rest' - Varicella (1 day), Scarlet fever (2 days), Pox i.e. small pox (3 days), Measles (4 days), Typhus (5 days) and Rubella (6 days). 2Usual appearance, may vary, special appearance in parentheses3Usual distribution and progression (gt;) from the site of first appearance
4Usual disappearance of primary rash, secondary lesions, e.g. staining (measles), scars (chickenpox), desquamation (scarlet fever, Kawasaki disease) may persist for 2-4 weeks.
• Rickettsial fevers
• Others: Purpura fulminans
All fevers with petechial/purpuric rash need hospitalization and close supervision for signs of internal bleeding, e.g. hematemesis, hematuria, etc. Some important hemorrhagic fevers are discussed later in relevant chapters.
10.1.5
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