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Differential diagnosis of measles exanthem

Differential diagnosis of measles exanthem
Viral infections associated with rash
Rubella Rubella infection is characterized by rash (resembling measles), fever, and lymphadenopathy (postauricular, posterior cervical, and/or suboccipital adenopathy); in general, symptoms are relatively mild.
Erythema infectiosum or "fifth disease" (human parvovirus B19) Children often develop a characteristic rash with a "slapped cheeks" appearance.
Roseola infantum or exanthem subitum (human herpesvirus 6 or 7) Primarily seen in infants and young children; roseola infantum is characterized by high fever (3 to 4 days) followed by generalized maculopapular rash that spreads from the trunk to the face and extremities.
Infectious mononucleosis (Epstein-Barr virus or cytomegalovirus) Infectious mononucleosis is characterized by pharyngitis, fever, and lymphadenopathy. Maculopapular rash usually occurs following administration of ampicillin.
HIV infection Primary HIV infection is characterized by fever, sore throat, malaise, headache, lymphadenopathy, and mucocutaneous ulceration. A transient, maculopapular, nonpruritic rash, located on the trunk or face, may occur 2 to 4 weeks after the primary HIV infection.
Bacterial infections associated with rash
Scarlet fever Scarlet fever is characterized by pharyngitis due to group A Streptococcus infection, accompanied by a coarse, sandpaper-like, erythematous, blanching rash.
Mycoplasma infection Mycoplasma infection is characterized by respiratory tract infection; in some cases, there may be associated mild erythematous maculopapular or vesicular rash. Rarely, erythema multiforme or Stevens-Johnson syndrome occurs.
Autoimmune connective tissue disease associated with rash
Juvenile idiopathic arthritis and adult-onset Still disease Rash consists of evanescent, salmon pink maculopapular rash occurring with fever. The rash predominantly involves the trunk and extremities but can also involve the palms, soles, and occasionally the face.
Acute cutaneous lupus erythematosus Rash consists of widespread eruption, often focused over the extensor aspects of the arms and hands; it is typically precipitated or exacerbated by exposure to ultraviolet light.
Graphic 102213 Version 2.0

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