A 14 month-old female is brought to your office with a 3-day history of a fever of 104 degrees rectally. Suddenly, today, the fever stopped and a rash developed. Examination reveals a diffuse, fine, maculopapular rash. Presently, the child does not appear ill. The most likely diagnosis is:
A. Rubella
B. Rubeola
C. erythema infectiosum (Fifth's disease)
D. Roseola
E. Chicken pox
Answer: D, Roseola
This is typical for Roseola. Rubella has mild illness with a fine macular rash. Rubeola (measles) is an acute illness, the child is toxic, has conjunctivitis and Koplik spots. Fifth's disease has mild illness with a "lacey" rash on the extremities. Chicken pox has vesicles.
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