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Annals of Dermatology 2012 Oct; 24(4): 420~425
Annals of Dermatology 2012 Oct; 24(4): 420~425

Clinical Features and Etiology of Adult Patients with Fever and Rash
Fehmi Tabak, M.D., Aysan Murtezaoglu, M.D., Omur Tabak, M.D.1, Resat Ozaras, M.D., Bilgul Mete, M.D., Zekayi Kutlubay, M.D.2, Ali Mert, M.D., Recep Ozturk, M.D.
Department of Infectious Diseases and Clinical Microbiology, 2Department of Dermatology, Cerrahpasa Medical Faculty, Istanbul University, 1Internal Medicine, Istanbul Education and Research Hospital, Istanbul, Tutkey
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Patients with fever and rash often pose an urgent diagnostic and therapeutic dilemma for the clinician. The nonspecificity of many fever and rash syndromes mandates a systemic approach to diagnosis. Objective: We aimed to determine the etiology of fever and rash in 100 adult patients followed-up as in- or outpatients prospectively. Methods: All the patients, who presented with rash and fever, were followed-up prospectively and their clinical and laboratory studies were evaluated. Results: The median age was 35 years (14∼79 years); 45 were female and 55 were male. Patients were divided into 3 groups according to the etiology: infectious (50%), noninfectious (40%) and undiagnosed (10%). The most common type of rash was maculopapular, and the most common 5 causes were measles, cutaneous drug reactions, varicella, adult-onset Still's disease (ASD) and rickettsial disease. Viral diseases among infectious causes and cutaneous drug reactions, among the noninfectious causes, were determined as the main diseases. The mortality rate was 5% and the reasons of mortality were as follows: toxic epidermal necrolysis (2 patients), ASD (1), staphylococcal toxic shock syndrome (1) and graft-versus-host disease (1). Conclusion: Adult patients with fever and rash had a wide differential diagnosis. The most common type of rash was determined as maculopapular, and the most frequent five diseases were measles, drug reactions, chickenpox, ASD and rickettsial infection. Viral diseases among infectious causes and drug reactions among noninfectious causes were determined as the leading etiologies. (Ann Dermatol 24(4) 420∼425, 2012)
Annals of Dermatology 2012 Oct; 24(4): 420~425
Keyword : Exanthema, Fever, Infection
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