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Fever, body rash, tender nodule, pregnant. Suggestion?

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Practicing since : 1996
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hello doctor,my query is--30 year old female,8 weeks pregnant,3 days h/o fever(100-101 celsius),2 days h/o generalized body rash,1 day h/o tender nodule b/l mastoid process.any possibility apart from viral?what would be the suggested management?
Posted Mon, 30 Apr 2012 in Skin Hair and Nails
Answered by Dr. Bharat Chawda 1 hour later

Thank you for posting the query,

You have provided with good information regarding your health concern and it is a very good description. I appreciate it.

As I believe that more information can help a physician reach an accurate diagnosis, I would request you to answer the following questions:
1) Are these rashes itchy?
2) Have you taken any drug (medicine) before you had developed these rashes?
3) What is the exact distribution of these rashes?
4) Do you have sore throat?
5) Any oral lesions?

Answer to these would help me suggest you better.

I shall address your concern based on your current given information.

With the history that you have submitted it seems to be a viral exanthem (viral fever) .The second possibility is of a drug reaction only if you had taken any medication which you were allergic to or if the rashes are very itchy. In a drug reaction, patients also develop oral lesions/ulcers most of the times.

A tender nodule near the mastoid could be a lymph node which can get inflamed in case you have a sore throat.

Usually medications are avoided in first trimester of pregnancy, but antipyretics can be taken for fever, along with calamine lotion for local application. But the exact management depends upon the diagnosis which can be done by seeing the lesions clinically.

I would suggest you to consult a dermatologist as soon as possible as most of the medications are prescription medications & the safety of the medication has to be taken into account in pregnancy.

However, if you can answer my above questions I would be able to help you better.

Awaiting your reply.

Dr.Bharat chawda XXXXXXX specialist, Dermatology.
Above answer was peer-reviewed by
Follow-up: Fever, body rash, tender nodule, pregnant. Suggestion? 42 minutes later
thanks for your prompt reply doctor and sorry for missing out on the asked aspects.the rash is NOT itchy,no rug history.the rash started from the back,dorsal aspect of hand,involved the face and now involving the flexor aspect of the arms.the dorsal lesions are apparently fading and flexor ones flaring up.h/o sore throat since one day and a few oral lesions are also present.does it point towards a rubella infection?you may well understand the concern.
Answered by Dr. Bharat Chawda 10 hours later

Thank you for the reply,

Since there is no drug history nor its itchy, rue out the chance of drug reaction.
Now as far as rubella (German measles) is concerned ,the rash usually starts from the face and then distributes to the body .The rash is light pink in color.Its a self limiting condition and usually takes 3 days time and thus is also called three day measles.The rashes are mildly itchy.

One can observe a red colored papule over the soft palate at times .Also there is swelling of lymphnodes especially occipital and cervical.

Since you have a sore throat its obvious to have a tender lymph node involved near mastoid.

I can understand your concern regarding rubella infection in pregnancy ,which can lead to infection to the infant leading to MMR earlier in your teans then it reduces the risk (off course you cannot take a vaccine now).

A Rubella IgM test can be done to confirm the diagnosis ,but its not always very specific.

I think you should consult a competent dermatologist nearby to confirm the diagnosis(even though the symptoms doesn't' suggests rubella).

Hope I have answered your query, Should you have additional concern regarding the same ,I would be happy to address it.

Please accept my answer in case you do not have further queries.

Dr.Bharat chawda XXXXXXX specialist, Dermatology.
Above answer was peer-reviewed by
Follow-up: Fever, body rash, tender nodule, pregnant. Suggestion? 9 hours later
thanks a lot doctor..i appreciate your the way i am really sorry to have not recognized you earlier.i was a consultant radiation oncologist in apollo BSR hospital for a brief period of time and have met you once.thanks a lot again.warm regards ..Dr XXXXXXX
Answered by Dr. Bharat Chawda 4 hours later

What a pleasant surprise. The world is indeed a small place.

No wonder an intelligent question coming from a doctor,I should have guessed.

I thank you again for submitting your question. I hope you found my response to be helpful and informative. If you have any additional concerns, I would be happy to address them. In fact, you should consult a dermatologist so that he can see the lesions clinically and decide the management.

If you need anything from my side, just let me know.

Wish you good health.

Dr.Bharat chawda XXXXXXX specialist, Dermatology.
Above answer was peer-reviewed by
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