Caption: FIGURE 1: Macular rash
over the right knee.
On July 7, a child aged 6 years presented to a physician with a 1-day history of a temperature of 102.2 F (39.0 C), headache, myalgia, diarrhea, and a macular rash
on the arms, legs, palms, and soles.
Physical examination noted conjunctival suffusion, epistaxis, posterior cervical and inguinal lymphadenopathy, bilaterally diminished breath sounds, rhonchi and crackles, bloody cough, tachycardia, hepatosplenomegaly, and a macular rash
over the lower extremities.
On the next day, a macular rash
appeared on his arms and legs, associated with muscle and joint pain.
felis infections may have common clinical manifestations, such as fever, headache, myalgia, macular rash
, and elevated levels of liver enzymes (4,5).
A discrete macular rash
and pharyngitis were observed.
Symptoms included fever and a macular rash
; laboratory findings showed elevated serum C-reactive protein (CRP) (37 mg/L) and AST (59 IU/L).
A transient macular rash
is often seen on day 1 to day 2 of illness.
Of those persons in whom symptoms develop, most have self-limited West Nile fever (WNF), characterized by the acute onset of fever, headache, fatigue, malaise, muscle pain, and weakness; gastrointestinal symptoms and a transient macular rash
on the trunk and extremities are sometimes reported (15,16).