Articles: exanthema-etiology.
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Adult onset Still's disease (AOSD) is a systemic disorder characterized by intermittent fever, evanescent rash, polyarthralgia or arthritis, and neutrophilic leucocytoclasis. Appearance of skin rash during fever episodes is the characteristic feature. ⋯ The purpose of this report is to describe the first case of atypical AOSD in a genetically black-skinned woman. Treatment required administration of high-dose systemic corticosteroids.
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A 29-year-old hospital doctor presented with a febrile illness and a rash that began shortly after commencing a course of oral antibiotics. Initially thought to be a drug reaction, changes in the nature of the rash led to a confirmed diagnosis of measles. An immunisation history revealed that the patient had never received the MMR vaccine. A high index of suspicion is required to diagnose measles in an immunocompetent adult, and we suggest that occupational health departments should be more rigorous in screening for vaccinations in health workers.
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Nihon Kokyuki Gakkai Zasshi · Sep 2007
Case Reports[A case of sarcoidosis presenting with high fever and rash progressing to acute respiratory failure].
A 66-year-old man who had been given a clinical diagnosis of vasculitis at another hospital after presenting with high fever and rash was admitted to our hospital for further examination following a relapse of fever during steroid reduction. The biopsy specimens of the leg with crusts showed the presence of epithelioid granuloma, and because of a negative tuberculin test, increased serum angiotensin converting enzyme (ACE) and lysozyme levels, and pulmonary Ga uptake, the patient was given a diagnosis of sarcoidosis. Although the patient had been treated on an outpatient basis following resolution of fever with NSAIDs and 5 mg prednisolone (PSL), he suffered acute respiratory failure during follow-up and required emergency admission. ⋯ We diagnosed acute exacerbation of sarcoidosis and given high dose steroid therapy. The patient's symptoms, image findings, blood test results, and other findings promptly improved. Here we reported a highly unusual presentation of acute respiratory failure in sarcoidosis.