Dermatologic Manifestations of Infectious Disease
Toxic infectious exfoliative conditions include staphylococcal toxic shock syndrome (TSS), streptococcal toxic shock syndrome (STSS), and staphylococcal scalded skin syndrome (SSSS). All three are mediated by bacterial toxin production and are considerations in the differential diagnosis of a febrile, hypotensive patient with a rash. Meningococcemia is potentially fatal and extremely contagious with a short incubation period. Disseminated gonococcal infection (DGI) presents with tenosynovitis, dermatitis, and polyarthralgias without purulent arthritis or with purulent arthritis but without skin lesions. Ecthyma gangrenosum (EG) is a cutaneous manifestation of Pseudomonas aeruginosa infection. Rocky Mountain Spotted Fever (RMSF) is caused by Rickettsia rickettsii, most commonly transmitted by the American dog tick. Patients present with nonspecific symptoms, such as fever, headache, myalgias, arthralgias, nausea, vomiting, and abdominal pain. Finally, vibrio vulnificus is a gram-negative bacterium that causes serious wound infections, sepsis, and diarrhea in patients exposed to shellfish or marine water.