BACKGROUND: Patients with fever and rash often pose an urgent diagnostic and therapeutic dilemma for the clinician. The nonspecificity of many fever and rash syndromes mandates a systemic approach to diagnosis. OBJECTIVE: We aimed to determine the etiology of fever and rash in 100 adult patients followed-up as in- or outpatients prospectively. METHODS: All the patients, who presented with rash and fever, were followed-up prospectively and their clinical and laboratory studies were evaluated. RESULTS: The median age was 35 years (14~79 years); 45 were female and 55 were male. Patients were divided into 3 groups according to the etiology: infectious (50%), noninfectious (40%) and undiagnosed (10%). The most common type of rash was maculopapular, and the most common 5 causes were measles, cutaneous drug reactions, varicella, adult-onset Still's disease (ASD) and rickettsial disease. Viral diseases among infectious causes and cutaneous drug reactions, among the noninfectious causes, were determined as the main diseases. The mortality rate was 5% and the reasons of mortality were as follows: toxic epidermal necrolysis (2 patients), ASD (1), staphylococcal toxic shock syndrome (1) and graft-versus-host disease (1). CONCLUSION: Adult patients with fever and rash had a wide differential diagnosis. The most common type of rash was determined as maculopapular, and the most frequent five diseases were measles, drug reactions, chickenpox, ASD and rickettsial infection. Viral diseases among infectious causes and drug reactions among noninfectious causes were determined as the leading etiologies.
Adult ; Chickenpox ; Diagnosis, Differential ; Epidermal Necrolysis, Toxic ; Exanthema ; Female ; Fever ; Graft vs Host Disease ; Humans ; Male ; Measles ; Outpatients ; Prospective Studies ; Shock, Septic ; Still's Disease, Adult-Onset ; Virus Diseases

This paper describes the first case of common variable immunodeficiency (CVID) and AA amyloidosis. A recently treated tuberculosis, and chronic inflammation induced by frequent respiratory tract infections, were thought to be responsible for the amyloidosis. No other reason for this condition could be detected. Although T cell dysfunction in some CVID patients has been reported, pulmonary tuberculosis is quite rare with this condition. Bacterial or viral agents or evidence in favour of intestinal tuberculosis, which would explain this patient's recurrent diarrhea, were not found. In this case, the response of the attacks of diarrhea to metranidazole and the histologic observation of extensive intestinal amyloid deposition, which is known to decrease intestinal motility, made us conclude that the diarrhea was associated with bacterial overgrowth. In this report, we discuss the association of CVID and tuberculosis to secondary amyloidosis and recurrent diarrhea.
Tuberculosis/*complications ; Male ; Humans ; Diarrhea/etiology ; Common Variable Immunodeficiency/*complications ; Amyloidosis/*etiology/pathology ; Adult

Humans ; COVID-19 ; Alanine Transaminase ; Aspartate Aminotransferases ; Prognosis