Child with fever and rash- differentials

In children < 15 - fever with rash is a common presentation

A diagnostic challenge ( broad differential diagnosis ) as several life threatening conditions can also present with fever and rash

Careful history taking and a thorough examination are essential part of assessment- majority of children are not seriously unwell and can be managed with reassurance / advice

History of rash - onset

where did it start / rapid spread ?

pattern of spread / progression

blanching or non blanching

appearance in relation to fever( fever often precedes the appearance of rash )

rash getting better or worse

has the rash changed over time ( appearance sensation )

involvement of palms / sole / mucus membranes

rash fixed or moves

itch / pain

previous episodes of rash

Symptoms associated with rash - relationship rash and fever

fever / character / duration( acute , insidious , relapsing )

prodromal symptoms ( malaise , catarrhal , sore throat before rash indicate viral exanthemas )

irritability

headache

respiratory symptoms - cough , runny nose

diarrhoea

headache , vomiting ,photophobia

eye changes

joint pain / swelling

itching.

History -h/o travel abroad

contact with a person who is ill

exposure to insects / animals...