Fever and blisters on the trunk (19/1700)

A 47yo man has a temp of 39C and is delirious. He has developed blisters mainly on his trunk,
which appeared a few hours ago. He is well and not on any medications. He last travelled 5
months ago to Italy. Which of the following is the most likely dx?
a. Shingles
b. Chicken pox
c. Pemphigoid
d. Bullous pemphigus


















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answer B:
no delirium/fever in pemphigoid
shingles follows dermatomal pattern

chicken pox in adults

What are the symptoms of chickenpox?

Symptoms are usually more severe in adults than in children. Expect to have a few uncomfortable days.

• High temperature (fever), aches and headache often start a day or so before a rash appears.
• Spots (a rash). Spots appear in crops. The spots develop into small blisters and are itchy. They can be anywhere on the body and sometimes also in the mouth. Several crops may develop over several days. Some people are covered in spots; others have only a few.
• Loss of appetite, tiredness and feeling sick are common.

The fever and generally feeling unwell can last several days. The blisters gradually dry up and scab. They slowly fade over a week or so, but may take 2-3 weeks to go completely.