Diagnósticos diferenciais
Rubella
SINAIS / SINTOMAS
Typically a mild illness with patient and rash improving in about 3 days.
Investigações
Rubella-specific IgM antibody or other specific test for rubella.
Scarlet fever
SINAIS / SINTOMAS
Pharyngitis, anterior cervical adenopathy, and fever precede characteristic scarlatiniform rash (diffuse, finely papular, 'sandpaper-like', erythematous rash that blanches with pressure). Rash begins on the trunk and may spread; it is accentuated in flexural creases (i.e., under the arm, in the groin, in the elbows) often with petechiae, producing red streaks known as Pastia's lines. Cheeks flushed 'scarlet' with circumoral pallor. Skin desquamation may occur 3-4 days after appearance of the scarlatiniform rash. Tongue may be inflamed with a white coating and prominent papillae ('strawberry tongue').
Investigações
Group A streptococcal rapid antigen test; polymerase chain reaction test, or throat/skin swab culture. Diagnosis is often clinical.
Parvovirus B19
SINAIS / SINTOMAS
Typically a mild illness, associated classically with rash initially presenting with "slapped cheek" appearance, followed by lacy, reticular lesions; may have associated arthritis and/or anemia. Fever has usually subsided before rash develops. Occurs much more commonly in the US than measles.
Investigações
Parvovirus specific antibody detection.
Roseola
SINAIS / SINTOMAS
Rash appears after fever breaks.
Investigações
Specific test for human herpes virus 6 or human herpes virus 7.
Dengue
SINAIS / SINTOMAS
Febrile illness in which headache and body aches are prominent. Rash may be petechial. Appropriate exposure including exposure to mosquitoes that may carry dengue.
Investigações
Specific test for dengue antibody or antigen.
EBV infection (mononucleosis)
SINAIS / SINTOMAS
Febrile illness that may involve sore throat, pharyngeal exudates, and hepatosplenomegaly.
Investigações
Specific test for EBV antibody. Monospot for children over age 4 years.
Zika virus infection
SINAIS / SINTOMAS
Mild febrile illness with itchy rash, headache, joint pain, and conjunctivitis. Appropriate exposure including exposure to mosquitoes that may carry Zika virus.
Investigações
Specific test for Zika antibody.
Drug eruptions
SINAIS / SINTOMAS
History of recent medication or drug ingestion.
Investigações
No differentiating tests.
Coronavirus disease 2019 (COVID-19)
SINAIS / SINTOMAS
Residence in/travel to a country/area or territory with local transmission, or close contact with a confirmed or probable case of COVID-19, in the 14 days prior to symptom onset.
The situation is evolving rapidly; see our COVID-19 topic for further information.
Investigações
Real-time reverse transcription polymerase chain reaction (RT-PCR): positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA.
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