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Mucocutaneous Symptom Complexes
Book chapter

Mucocutaneous Symptom Complexes

Sarah S. Long and Ishminder Kaur
Principles and Practice of Pediatric Infectious Diseases, pp 108-115
2018

Abstract

Generally, in differentiating between bacterial and viral causes of febrile illnesses in children, the more mucous membranes involved in the patient’s illness (e.g., conjunctiva, throat, respiratory, gastrointestinal tract), the more likely the cause is viral. When multiple mucous membranes are involved and an exanthem (i.e., mucocutaneous complex) is present, a self-limited viral cause is likely, but other important diagnoses must be considered. These commonly include inflammatory or immunologically mediated conditions, such as Kawasaki disease (KD), Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN), drug hypersensitivity, and bacterial toxin-mediated diseases, including staphylococcal and streptococcal toxic shock, streptococcal scarlatiniform disorders, and staphylococcal exfoliative toxin syndromes or staphylococcal scaldedskin syndrome. A best, if not the definitive, diagnosis can be deduced through careful assessment of (1) the dominant features of the illness; (2) prodromal events and exposures; (3) specific characteristics of the exanthem and abnormality at each affected mucous membrane; and (4) the cadence of the developing constellation. Laboratory features are of secondary importance, heightening or diminishing the fitness of the clinical assessment.

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