鉴别诊断
Rubella
征象/症状
Typically a mild illness with patient and rash improving in about 3 days.
辅助检查
Rubella-specific IgM antibody or other specific test for rubella.
Scarlet fever
征象/症状
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').
辅助检查
Group A streptococcal rapid antigen test; polymerase chain reaction test, or throat/skin swab culture. Diagnosis is often clinical.
Parvovirus B19
征象/症状
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.
辅助检查
Parvovirus specific antibody detection.
Roseola
征象/症状
Rash appears after fever breaks.
辅助检查
Specific test for human herpes virus 6 or human herpes virus 7.
Dengue
征象/症状
Febrile illness in which headache and body aches are prominent. Rash may be petechial. Appropriate exposure including exposure to mosquitoes that may carry dengue.
辅助检查
Specific test for dengue antibody or antigen.
EBV infection (mononucleosis)
征象/症状
Febrile illness that may involve sore throat, pharyngeal exudates, and hepatosplenomegaly.
辅助检查
Specific test for EBV antibody. Monospot for children over age 4 years.
Zika virus infection
征象/症状
Mild febrile illness with itchy rash, headache, joint pain, and conjunctivitis. Appropriate exposure including exposure to mosquitoes that may carry Zika virus.
辅助检查
Specific test for Zika antibody.
Drug eruptions
征象/症状
History of recent drug ingestion.
辅助检查
No differentiating tests.
Coronavirus disease 2019 (COVID-19)
征象/症状
Important to consider current epidemiologic situation. May give history of unwell contacts.
Respiratory symptoms may be prominent.
辅助检查
Real-time reverse transcription polymerase chain reaction (RT-PCR): positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA. Rapid antigen tests may also be used.
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