Codes

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

• Other rickettsioses with eschar that are typically acquired outside the United States (eg, tick typhus, Mediterranean spotted fever, and scrub typhus).
• Varicella lesions (primary or post-vaccination) evolve in different stages (ie, they do not appear uniform) and often scar, whereas rickettsialpox lesions do not.
• Eczema herpeticum
• Eczema vaccinatum
• Gonococcemia
• Monkeypox
• Enteroviral infections
• Infectious mononucleosis
• Cutaneous anthrax
• Spider bite
• Acute meningococcemia (early)
• The lesions of smallpox are deeper and larger and are prominent on the face (this has been eradicated but remains a bioterrorism threat).

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Therapy

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References

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