Measles, rubella, and varicella can present with a rash and fever. There is some variability to the timing of each sign and symptom. Each exanthem has classic clinical features, but some similarities may exist. Varicella typically presents as a vesicular exanthem, but it can be macular as well as pustular, depending on the stage of the crop of lesions. Measles, rubella, and varicella exanthems are not petechial or purpuric, which can differentiate them from other life-threatening etiologies, such as meningococcemia. Fever may precede or follow the onset of the rash. In measles and rubella, fever typically precedes the onset of a maculopapular rash. Table 2 lists potential etiologies in the differential diagnosis for these diseases.
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