作为微生物感染的表现的发热和皮疹统称为高热症。由于病毒更经常与发烧和皮疹有关,因此,这些症状被强烈地称为病毒exanthem。然而,细菌是引起人类皮疹的一种经常被忽视的感染性病因。此外,某些微生物可能表现出疾病期间爆发的病理特征,并有助于临床诊断。相反,合并感染通常会掩盖原发疾病的临床特征,并进一步挑战试图做出诊断的临床医生。我们回顾性研究了一名患者的临床数据,该患者于2019年7月就诊于曼谷热带病医院,抱怨发烧和皮疹。该病例涉及一名35岁的人,他有3天的发烧史,呼吸道症状,肌痛,结膜炎,腹泻,和泛发性斑丘疹.在检查中,病人发热,心动过速,和快感,平均动脉压为95mmHg.差别白细胞计数显示:白细胞,5800/微升;中性粒细胞,4408/微升;淋巴细胞,406/微升;和血小板,155,000/微升。涉及表皮系统的醒目发现包括Koplik斑点和泛发性斑丘疹。进一步的血清学显示麻疹和风疹病毒免疫球蛋白(Ig)M和IgG阳性,包括梅毒螺旋体的反应性血清学。在这里,我们描述了该患者的临床过程和管理。
Fever and rash as manifestations of infection by microorganisms are collectively known as febrile exanthem. Since viruses are more frequently associated with fever and rash, these symptoms are thus impetuously termed viral exanthem. However, bacteria represent a frequently overlooked infectious etiology causing rash in humans. In addition, certain microbes may exhibit pathognomonic features that erupt during illness and facilitate clinical diagnosis. Conversely, coinfections often obscure the clinical characteristics of the primary disease and further challenge clinicians attempting to reach a diagnosis. We retrospectively looked at de-identified clinical data of a patient who presented to the Hospital for Tropical Diseases in Bangkok in July 2019 with complaints of fever and rash. The
case involved a 35-year-old who presented with a 3-day history of fever, respiratory symptoms, myalgia, conjunctivitis, diarrhea, and a generalized maculopapular rash. On examination, the patient was febrile, tachycardic, and tachypneic, with a mean arterial pressure of 95 mmHg. A differential white blood cell count showed: leukocytes, 5800/µL; neutrophils, 4408/µL; lymphocytes, 406/µL; and platelets, 155,000/µL. Striking findings involving the integumentary system included Koplik\'s spots and generalized maculopapular rash. Further serology revealed positive immunoglobulin (Ig)M and IgG for both measles and rubella virus, including reactive serology for Treponema pallidum. Here we describe the clinical course and management of this patient.