Skin rashes and fever in adults could signal life-threatening conditions

Adults with skin rashes accompanied by a fever of 100.5 or higher warrant a trip to the emergency room because the combination of symptoms can be associated with several life-threatening conditions, according to the American College of Osteopathic Emergency Physicians.

Taken individually, rashes and fevers may seem benign, but the combination can be indicative of serious or life-threatening illness in adults. Survival rates increase dramatically for patients who receive quick, aggressive treatment for the underlying cause of the rash, said Christine Giesa, DO, FACOEP-d, director of osteopathic medical education for Crozer-Keystone Health System in Pennsylvania.

"People often think of a rash as a nuisance ailment and delay treatment. But the tenets of osteopathic medicine teach us that rash with fever is a clear indication of an acute systemic illness requiring further investigation and, in some cases, life-saving intervention," said Dr. Giesa. "By taking a whole person approach to uncovering the root cause of these symptoms, we're able to identify and treat conditions that can quickly turn fatal."

Toxic shock syndrome (TSS), initially associated with tampon use in the 1980s, remains a top concern. While mortality rates for menstrual-related cases of TSS have dropped to less than 5 percent, the occurrence rate remains relatively unchanged. Non-menstrual cases of TSS, sometimes stemming from surgery or injury, affect patients of all ages and genders and are three times more likely to be fatal.

Dr. Giesa will review the most life-threatening cases in a lecture, Rashes That Kill, at OMED 15 October 17-21 in Orlando. Some of the most serious rash-related illnesses are:

• Toxic Shock Syndrome, caused by a bacterial infection
• Toxic Epidermal Necrolysis, often caused by medication
• Staph Scalded Skin Syndrome, caused by a bacterial infection
• Rocky Mountain Spotted Fever, caused by ticks
• Meningococcemia, an airborne bacteria
• Purpura Fulminans, a thrombotic disorder
• Strep Toxic Shock Syndrome, caused by a bacterial infection

These conditions are relatively rare and notoriously difficult to diagnosis, Dr. Giesa explained, making it important for patients and physicians to understand the need to seek quick medical attention.

"Children often contract mild viral illnesses that cause rashes accompanied by a fever. In an adult population, the combination demands further investigation to identify the underlying illness at its earliest, most treatable stage," she explained.