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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3 responses to “Fever with rash – Infection or Allergy ?”

  1. mohd zaqrul razmal Avatar
    mohd zaqrul razmal

    Assalamualaikum nadz, I am sorry for the lqte reply, mycoplasma pneumonia infection can be very serious and commonly occur to the school age children. Mycoplasma infections ranges from mild (fever) to severe infection ( severe pneumonia). The infection usually occur to school age children and commonly the diagnosis is based on suspicious and confirmation with mycoplasma serology. Since there the symptoms are non specific I would say there is no definite alarming symptoms or signs to suggest mycoplasma infection. Hope I answer your question. ..jazakallahu khaira

  2. Mazyu Syaziana Yusof Avatar
    Mazyu Syaziana Yusof

    Dear dr,

    Thank you so much for your kind response. We’ve done blood rest at day 3 of fever and no dengue is ruled out. My baby has a combination if bacteria infection abd viral fever hence the antibiotics. However, i have checked with my baby’s peaditrician on the rashes and it seems that it is heat rash.

    Again, thank you so much for you kind and prompt response.

  3. nadz Avatar
    nadz

    Salam alaik dr.

    I’ve come across a child of about 4-5 years old who developed urticaric-like rashes then followed by mild fever and runny nose. Initially the parents thought that the child had allergy towards seafood. (but the child never had any allergy before).The rash lasted for few days, and the child later been diagnosed to have mycoplasma pneumonia. The child was treated at home and fully recovered.

    my question is, what is the alarming sign of mycoplasma pneumonia that shouldnt been missed?

    Thank you for your attention.