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Pyrexia of unknown origin 

Pyrexia of unknown origin
Chapter:
Pyrexia of unknown origin
DOI:
10.1093/med/9780198729228.003.0025
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date: 19 November 2019

Skin rashes or exanthems are among the commonest clinical presentations in childhood. They are associated with a wide range of infectious diseases, ranging from benign, self-limiting illnesses to severe, life-threatening infections, and the aetiology and epidemiology of the commonest causes of exanthems are examined here. Diagnosis is particularly important in severe infection and the immunocompromised host, and when there is contact with a pregnant woman. This chapter focuses on the clinical distinction between different causes of a rash. Distinguishing features in the history include prodromal symptoms, evolution of the rash, associated symptoms, infection exposure, foreign travel, time of year, immunization, and drug history. Key features on examination are the morphological nature of the rash, its distribution, the presence of oral enanthems, and other clinical features. Incubation, infectivity, investigations, and management are discussed. Specific rashes not covered elsewhere are also included: Gianotti–Crosti syndrome, unilateral laterothoracic exanthem, papular purpuric gloves and socks syndrome, pityriasis rosea, and rickettsial rashes.

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