6. A Rash Decision

  1. James C. Pile4,
  2. Thomas E. Baudendistel5 and
  3. Brian J. Harte6
  1. Brian J. Harte6,
  2. Gurpreet Dhaliwal1,2,
  3. Wendy Armstrong3 and
  4. James C. Pile4

Published Online: 21 MAR 2013

DOI: 10.1002/9781118483206.ch6

Clinical Care Conundrums: Challenging Diagnoses in Hospital Medicine

Clinical Care Conundrums: Challenging Diagnoses in Hospital Medicine

How to Cite

Harte, B. J., Dhaliwal, G., Armstrong, W. and Pile, J. C. (2013) A Rash Decision, in Clinical Care Conundrums: Challenging Diagnoses in Hospital Medicine (eds J. C. Pile, T. E. Baudendistel and B. J. Harte), John Wiley & Sons, Inc., Hoboken, NJ, USA. doi: 10.1002/9781118483206.ch6

Editor Information

  1. 4

    Departments of Hospital Medicine and Infectious Diseases, Cleveland Clinic, Cleveland, Ohio, USA

  2. 5

    Department of Medicine, Kaiser Permanente Medical Center, Oakland, California, USA

  3. 6

    South Pointe Hospital, Cleveland Clinic Health System, Warrensville Heights, Ohio, USA

Author Information

  1. 1

    Department of Medicine, University of California, San Francisco, California, USA

  2. 2

    Medical Service, San Francisco VA Medical Center, San Francisco, California, USA

  3. 3

    Department of Infectious Disease, Emory University School of Medicine, Atlanta, Georgia

  4. 4

    Departments of Hospital Medicine and Infectious Diseases, Cleveland Clinic, Cleveland, Ohio, USA

  5. 6

    South Pointe Hospital, Cleveland Clinic Health System, Warrensville Heights, Ohio, USA

Publication History

  1. Published Online: 21 MAR 2013
  2. Published Print: 15 MAR 2013

Book Series:

  1. Hospital Medicine: Current Concepts

Book Series Editors:

  1. Scott A. Flanders and
  2. Sanjay Saint

ISBN Information

Print ISBN: 9780470905654

Online ISBN: 9781118483206

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Keywords:

  • antibodies;
  • etiology;
  • fever of unknown origin (FUO);
  • HIV;
  • prozone phenomenon;
  • rapid plasma reagin (RPR);
  • syphilis;
  • truncal rash

Summary

HIV-associated fever of unknown origin (FUO) can be a diagnostic challenge, but an etiology can be found in most cases. Syphilis continues to be an unusual cause of FUO and can have protean manifestations affecting nearly every organ system. The manifestations of secondary syphilis are protean, including a variety of rashes, aphthous ulcers, arthralgias, pharyngitis, weight loss and fever, The sensitivity of rapid plasma reagin (RPR) is extremely high in secondary syphilis, but false-negative tests can be seen in HIV because of both the prozone phenomenon and a delayed rise in antibodies.