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Differential diagnosis of fever and rash based upon appearance of the rash

Differential diagnosis of fever and rash based upon appearance of the rash
Macules, papules, nodules, or plaques Vesicles, bullae, or pustules Purpuric macules, purpuric papules, or purpuric vesicles Widespread erythema with or without edema followed by desquamation
Fungal

Blastomyces dermatitidis*

Candida spp

Coccidioides immitis

Cryptococcus neoformans

Histoplasma capsulatum

Other disseminated deep fungal infections in immunocompromised patients		 Histoplasma capsulatum    
Viral

Adenovirus

Arbovirus

Atypical measles*

Chikungunya virus

Colorado tick fever

Coxsackieviruses A and B

Cytomegalovirus, primary infection

Dengue virus

Epstein-Barr virus, primary infection

Echoviruses

Hepatitis B (urticaria)*

Human herpesvirus 6 (exanthem subitum)*

Human immunodeficiency virus (HIV-1)*

Kawasaki syndrome (presumed viral)

Molluscum contagiosum

Orf

Parvovirus B19 (erythema infectiosum [fifth disease])

Rubella (German measles)*

Rubeola (measles)*

Varicella (chickenpox)*

Varicella-zoster (disseminated)

Viral hemorrhagic fevers (many)

West Nile virus

Zika virus

Colorado tick fever

Coxsackie A5, 9, 10, 16, B2, 7

Echoviruses

Eczema herpeticumΔ

Herpes simplex (disseminated)Δ

Varicella (chickenpox)Δ

Varicella-zoster (disseminated)Δ

Adenovirus (rare)

Atypical measles*

Chikungunya virus

Colorado tick fever

Congenital cytomegalovirus

Coxsackie A and B (rare, types A-9, B2-5)

Dengue fever

Epstein-Barr virus (rare)

Echoviruses (rare, types 3, 4, 9)

Rubella*

Varicella-zoster virus

West Nile virus

Yellow fever		 Kawasaki syndrome (presumed viral)
* Reportable disease.
¶ May have arthralgia or musculoskeletal pain.
Δ Umbilicated papule or vesicle a characteristic of these exanthems.
Adapted with permission from: Sanders CV. Diagnosis of the patient with fever and rash. In: The Skin and Infection: A Color Atlas and Text, Sanders CV, Nesbitt LT (Eds), Williams & Wilkins, Baltimore, 1995. Originally modified with permission from Fitzpatrick TB, et al: Color Atlas & Synopsis of Clinical Dermatology - Common and Serious Diseases. Fitzgerald TB, et al (Eds), McGraw-Hill, New York, 1992.
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