Evaluating Febrile Patients with Rash

Urgent message: The broad differential diagnoses in patients presenting with rash and fever range from minor conditions to life threatening illnesses, requiring the urgent care provider to make prompt but valid assessment with minimal diagnostic tools. Kosta G. Skandamis, MD The combination of fever and rash is so common that it may sometimes seem to be a daily occurrence in the urgent care setting. Nonetheless, the extensive differential diagnosis requires the provider to be vigilant …

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32-year old female with fever, rash and scattered vesicles

32-year old female with fever, rash and scattered vesicles

The patient is a 32-year-old female who presents complaining of a fever and a rash, along with a sore throat, headache, and fatigue. On clinical examination, you note vesicles on the palms and soles. An erosion is present at the labial mucosa. A small vesicle is present on the hard palate. The patient\’s temperature is 100.5°F. Her blood pressure and vital signs are within normal limits. View the photos and consider what your next steps …

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53-year-old woman presents with a red plaque on her calf

53-year-old woman presents with a red plaque on her calf

The patient is a 53-year-old woman who presents with a red plaque on her calf. She reports that she first noticed it two months ago. You find that the plaque is non-pruritic and asymptomatic. The patient, who is in good general health, admits no new medications and says that none of her family members have a rash or skin lesion of any kind. View the images and consider what your next steps would be.

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56-year-old man experiencing chest pain, fevers and rash

56-year-old man experiencing chest pain, fevers and rash

The patient is a 56-year-old man who emigrated from Mexico to Texas two months ago. He first presented about two weeks ago with a dry cough, chest pain, fevers, and night sweats. Chest x-ray showed a focal consolidation. He had received BCG vaccination as a child, so a PPD was not placed. He was started on isoniazid, rifampin, and ethambutol for tuberculosis. Now, he presents complaining of the same symptoms, plus a rash that erupted …

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