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4 - Systemic Diseases Causing Fever and Rash

from Part I - Systems

Published online by Cambridge University Press:  15 December 2009

By
Catherine A. Marco ,
Janel Kittredge-Sterling  and
Rachel L. Chin
Edited by
Rachel L. Chin
Catherine A. Marco
Affiliation:
Professor of Surgery Division of Emergency Medicine, University of Toledo College of Medicine, Toledo, OH
Janel Kittredge-Sterling
Affiliation:
St. Vincent Mercy Medical Center, Perrysburg, OH
Rachel L. Chin
Affiliation:
Editor in Chief, Professor of Emergency Medicine, University of California, San Francisco School of Medicine, San Francisco General Hospital, San Francisco, CA
Rachel L. Chin
Affiliation:
University of California, San Francisco
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Summary

INTRODUCTION – AGENTS

The clinical picture of fever and rash may be caused by a variety of agents, including bacterial, viral, rickettsial, or fungal infections, immunocompromised states, autoimmune conditions, and other systemic diseases. Knowledge of the epidemiology, pathophysiology, clinical presentations, and management of these conditions is essential for the acute care physician, as some of these conditions have significant time-dependent morbidity and mortality.

HISTORY AND PHYSICAL EXAMINATION

Crucial elements of the history and physical in the patient presenting with fever and rash are listed in Table 4.1.

SYSTEMIC BACTERIAL INFECTIONS

Secondary Syphilis

Syphilis is caused by the spirochete Treponema pallidum, which typically enters the body through mucous membranes or nonintact skin (Table 4.2). Syphilis is the third most common reportable sexually transmitted disease in the United States (after chlamydia and gonorrhea) and is spread almost exclusively through sexual contact, with some rare cases of transplacental transmission. Syphilis affects all ethnicities equally but has a male predilection. The incubation period is 2–90 days from exposure.

Primary syphilis presents as a painless genital chancre. (See Chapter 17, Ulcerative Sexually Transmitted Diseases.) Medical care is often delayed or not sought because the lesion is painless and usually resolves spontaneously though latent disease persists.

Type
Chapter
Information
Emergency Management of Infectious Diseases , pp. 21 - 32
Publisher: Cambridge University Press
Print publication year: 2008

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  • Systemic Diseases Causing Fever and Rash
    • By Catherine A. Marco, Professor of Surgery Division of Emergency Medicine, University of Toledo College of Medicine, Toledo, OH, Janel Kittredge-Sterling, St. Vincent Mercy Medical Center, Perrysburg, OH, Rachel L. Chin, Editor in Chief, Professor of Emergency Medicine, University of California, San Francisco School of Medicine, San Francisco General Hospital, San Francisco, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.005
Available formats
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Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Systemic Diseases Causing Fever and Rash
    • By Catherine A. Marco, Professor of Surgery Division of Emergency Medicine, University of Toledo College of Medicine, Toledo, OH, Janel Kittredge-Sterling, St. Vincent Mercy Medical Center, Perrysburg, OH, Rachel L. Chin, Editor in Chief, Professor of Emergency Medicine, University of California, San Francisco School of Medicine, San Francisco General Hospital, San Francisco, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.005
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Systemic Diseases Causing Fever and Rash
    • By Catherine A. Marco, Professor of Surgery Division of Emergency Medicine, University of Toledo College of Medicine, Toledo, OH, Janel Kittredge-Sterling, St. Vincent Mercy Medical Center, Perrysburg, OH, Rachel L. Chin, Editor in Chief, Professor of Emergency Medicine, University of California, San Francisco School of Medicine, San Francisco General Hospital, San Francisco, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.005
Available formats
×