3. Incubation Period: 3-8 days1
Common presentation:
◦ rapidly rising temp. >35oC
◦ severe headache, retro-orbital pain, myalgia,
arthralgia, nausea, and/or vomiting
◦ Hepatomegaly +/- splenomegaly
◦ hemorrhagic manifestations such as petechiae,
epistaxis, and gingival bleeding occur in some
patients.
1. Ligon BL. Dengue fever and Dengue Hemorrhagic fever: A review of history,
transmission, treatment and prevention. Semin Pediatr Infect Dis. 2004;16:60–
5.
4. Days of fever: 5 to 6 days, bi phasic
◦ Fever that lasts>10 days is probably not due to
dengue
◦ Of patients with dengue hemorrhagic fever, 90% are
younger than 15 years. 2
2. https://emedicine.medscape.com/article/215840-clinical
5. Rash:
◦ The initial rash is a transient flushing erythema of face
that typically occurs shortly before or within the first
24-48 hours of the onset of symptoms and is thought
to be the result of capillary dilatation.
◦ The typical rash begins on day 3 and persists 2-3 days.
◦ More than 50% of infected patients report having a rash
during this period that initially is macular or
maculopapular and becomes diffusely erythematous3
◦ The generalized rash characteristically starts on the
dorsum of the hands and feet and spreads to the arms,
legs, and torso and it lasts for several days and
subsides without desquamation.
◦ The morbilliform, maculopapular rash usually spares
palms and soles, and mostly subsides without
desquamation.
3. World Health Organization. Dengue fever in Indonesia. Available
from:http://www.who.int/csr/don/2004_02_26a/en/index.html [last accessed
6.
7.
8.
9. Incubation period
◦ 1-2 weeks
Common presentation
◦ Fever is abrupt onset, High grade, a/w myalgia,
headache & arthralgia
◦ Rash
◦ Hepatosplenomegaly and lymphadenopathy
◦ Edema
Narayanasamy DK, Arunagirinathan AK, Kumar RK, Raghavendran VD. Clinico -
laboratory profile of scrub typhus - An emerging rickettsiosis in India. Indian J
10. Rash
◦ SFG: appears on 2nd -5th day of illness, can be
pruritic, evolving: macular, maculopapular,
petechial, purpuric or gangrenous
◦ Centripetal spread
◦ Can involve palms and soles: typical of rickettsia
◦ ESCHAR: crusty necrotic lesion with or without
surrounding erythematous halo, suggest location of
vector bite.
◦ it is non pruritic, painless, about 1 cm, usually
single, a/w regional lymphadenopathy; uncommon
in SFG, more common in scrub tyhus
Days of fever
◦ Generally more than 5 days
◦ 3 to 4 weeks
11. Incubation: 1-7 days
Presentation:
◦ Sore throat, painful swallowing
◦ Fever - typically over 39 °C (102.2 °F)
◦ Fatigue
◦ Enlarged and reddened tonsils with yellow or white
exudates present (this is typically an exudative
pharyngitis)
◦ Enlarged and tender lymph nodes usually located
on the front of the neck
Goldsmith, Lowell; Katz, Stephen; Gilchrist, Barbara; Paller, Amy; Leffell, David;
Wolff, Klaus (2012). Fitzpatrick's Dermatology in General Medicine. McGraw Hill.
^ Jump up to:a b c d e f Usatine, Richard (2013). Color Atlas of Family Medicine,
Second Edition. McGraw Hill Companies.
12. Rash
◦ Begins 1-2 days after onset of symptoms of strep
pharyngitis
◦ “scarlantiform” :diffuse redness of skin with small
papules, or bumps, which resemble goose pimples;
can be itchy, blanchable but not painful
◦ First appears on trunk and then spreads to arms
and thighs
◦ Face, palms and soles are usually uninvolved
◦ Palate: forscheimer spots
◦ Rash fades in 3 to 4 days followed by desquamation
of the rash which will last several weeks to a month
Duration of fever
◦ 5 to 10 days, if not complicated.
13. Red cheeks
and pale area
around the
mouth in
scarlet fever
The rash of scarlet fever
14. Infection Common presentation Days of Fever Rash
Dengue Bi phasic break bone fever
Hypotension
hemorrhage
<7 days
Rickettsia Similar to dengue fever
With persistent intractable
headache
With rash and eschar
Toxic, confusion delirium
GI symptoms+
Can be
prolonged upto
4 weeks
Scarlet Sore throat
Fever rash
Enlarged tonsils
Enlarged LN
<7 days
KAWASAKI
DISEASE
High persistent fever not
responsive to PCM
Non purulent
conjunctivitis
Unilateral cervical LN+
Rash
Edema
1-2 weeks high
grade fever,
subacute upto
6 weeks
