Aetiology

Fever and rash in children can be caused by a multitude of conditions including:

• Septicaemia
• Slapped cheek syndrome (Fifth Disease or Parvovirus B19)
• Hand, foot and mouth disease
• Scarlet fever
• Measles
• Urticaria (hives)
• Chickenpox
• Roseola
• Rubella

Clinical features

• Erythema toxicum (erythema toxicum neonatorum): this is a benign rash in newborns which consists of verythematous macules (flat red patches) papules (small bumps) and pustules
  • The eruption waxes and wanes over several days and rarely for more than a day
• Septicaemia: rapid development of a non-blanching purpuric skin rash, lethargy, headache, fever, rigors, vomiting
• Slapped cheek syndrome: rash on both cheeks, fever, upper respiratory tract infection symptoms.
• Hand, foot, and mouth disease: blisters on hands and feet, grey ulcerations in the buccal cavity, fever, lethargy
• Scarlet fever: coarse red rash on the cheeks, sore throat, headache, fever, 'sandpaper' texture rash, bright red tongue (’strawberry tongue’)
• Measles: erythematous, blanching maculopapular rash, fever, cough, runny nose, conjunctivitis, Koplik spots
• Urticaria: raised, itchy red rashes, usually not accompanied by fever
• Chickenpox: maculopapular vesicular rash that crusts over and forms blisters