Fever with rash – Infection or Allergy ?

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Q: ” Salam doctor, my baby is 9 months old. she is currently having viral fever and this is the fifth day and is on antibiotics. my question is, today i found out that she has a few red patches on the back, couldn’t find any on the other body parts. what could it be? could that be an allergic reaction? ” ( Syaziana )

A:  Waalaikumsalam Puan Syaziana, thank you for your question. Fever is a very common problem in young child and fever with rash will lead us to few possible diagnosis. Majority of cases with fever are caused by viral infection but as we are in Malaysia which is endemic area for dengue, any fever which lasted more than 3 days, majority of doctors will suggest for blood test to exclude dengue.

With limited information given, if your child is diagnosed as viral fever the antibiotic is not needed for her. If the rash appear within 24hours of consumption allergic reaction is very likely but rash in allergic cases tend to be very progressive.

Other possible diagnosis for her age is fifth disease or roseola infantum in which child will have fever for 5days and rash will appear on day 5-6 of illness and progress to be generalized for the next 24 hr but resolve completely in 48-72 hrs, at the onset of the rash the fever will subside.

The  important  symptoms that you have to monitor are the child activities is playing and oral intake because any lack of interest for her usual activities indicates the seriousness of the disease. Hope this answers your question. Have a nice day.

( answered by Dr Mohd Zaqrul )

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