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Measles Exanthem Erythematous Maculopapular Rash

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    • 1955 posts
    July 20, 2014 7:56:56 PM PDT

    Pertinet findings from the recent NEJM case.

    The differential diagnosis includes

    Rickettsial diseases are distributed all over the world but Mediterranean spotted fever (MSF), a zoonosis caused by Rickettsia conorii transmitted by the bites of the brown dog tick Rhipicephalus sanguineus, is the most common rickettsiosis occurring in the Mediterranean region. Since the patient did not report a tick bite, I would think this is slightly less likely.

    Mediterranean spotted fever

    In addition, only a few of the patients with MSF as the patient at NEJM case developed petechiae in the mouth, 

    "Patients may develop an enanthem known as Koplik's spots; they are considered pathognomonic for measles infection and occur approximately 48 hours before the characteristic exanthem"

    "Koplik's spots, seen as whitish elevations on an erythematous background opposite the molars (arrows), are pathognomic of measles.
    Measles Exanthem Erythematous Maculopapular Rash."

    This post was edited by DrSocial Admin at August 31, 2014 6:05:32 AM PDT