A healthy 55-year-old man presented to the emergency department with a 5-day history of a fever, arthralgia, and rash. He had noticed a non-coalescing maculopapular rash on his neck and trunk that subsequently spread to his extremities. A physical examination revealed non-exudative conjunctivitis and enanthem located on the soft palate, which were identified as Forchheimer spots (Picture), indicating a clinical diagnosis of rubella. Rubella RNA was detected with a pharyngeal swab using reverse transcriptase polymerase chain reaction, which confirmed the diagnosis. Forchheimer spots appear in about 20% of patients with rubella with enanthem as small, red spots on the soft palate, occasionally preceding a rash (1). These spots are not specific to rubella and can be seen in cases of measles, scarlet fever, and other systemic infections (1). However, in combination with clinical information, the presence of Forchheimer spots supports a diagnosis of rubella and indicates diagnostic testing and infection prevention efforts.
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The authors state that they have no Conflict of Interest (COI).
References
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