Nearly all patients infected with the human immunodeficiency virus (HIV) experience a fever and skin rash at some point after diagnosis.

A fever and rash are symptoms of an underlying medical condition. An estimated 80-90% of HIV patients develop fever and rash when they first become infected with HIV. This is because the virus is multiplying rapidly in the body and infecting immune cells. This phase generally lasts several weeks. Other common causes of fever and rash in HIV patients include allergic reactions to medications, infections, and a cancer called Kaposi's sarcoma (KS).

Rash is a general term that describes a change in color and texture in the skin. A rash generally causes temporary red patches or bumps in the skin, and it may be itchy and/or tender. The affected skin is often swollen.

A fever is an increase in normal body temperature. Healthy individuals typically have a body temperature of about 98.6 degrees Fahrenheit. The body temperature fluctuates by about one degree throughout the day. If a baby younger than 12 months old has a temperature higher than 100 degrees, a healthcare provider should be consulted immediately. Adults and children who have temperatures higher than 102 degrees that are not responding to medications, such as ibuprofen (Motrin®, Advil®), aspirin, or acetaminophen (Tylenol®), should consult their healthcare providers.

Once the underlying cause of fever and rash is treated, symptoms will gradually disappear. Allergic reactions to medications are usually severe and may require immediate treatment with epinephrine. Infections are treated with antimicrobials, and Kaposi's sarcoma has been treated with local and systemic therapies, such as radiation and chemotherapy.

Anaphylaxis: A skin rash and fever may be symptoms of a severe and potentially life-threatening reaction called anaphylaxis. The most serious symptoms of anaphylaxis include chest pain, difficulty breathing, shock, and loss of consciousness, all of which can be fatal. Patients should seek immediate medical treatment if these symptoms develop.

Febrile seizure: A febrile seizure occurs when an infant or young child develops a seizure or convulsions when he/she has a fever higher than 102 degrees Fahrenheit. Symptoms may include shaking or jerking of the arms or legs, fixed stare, eyes rolling back, heavy breathing, drooling, and bluish skin. Patients who experience these symptoms should be taken to the emergency department of a nearby hospital immediately.

Infection: Some infections that cause fever and rash may spread to multiple parts of the body and cause organ damage. For instance, a liver infection called hepatitis can potentially lead to liver failure. Therefore, HIV patients who experience symptoms of fever and rash should consult their healthcare providers to diagnose and treat the underlying cause.

Kaposi's sarcoma: Kaposi's sarcoma (KS) is a cancer that usually causes tumors to form in the tissues below the skin or face or in the mucous membranes of the nose, mouth, or anus. Patients typically suffer from lesions on the skin, which appear as raised blotches or lumps that may be purple, brown, or red. While the skin lesions may be disfiguring, they are not usually life threatening. In some cases, the lesions may be painful or cause swelling. However, if KS develops in the lungs, liver, or gastrointestinal tract, the disease may be life threatening because internal bleeding or difficulty breathing may develop. Patients should consult their healthcare providers if they experience symptoms of KS.

Stevens-Johnson syndrome: A skin rash and fever may be symptoms of a severe allergic reaction to medications, called Stevens-Johnson syndrome (SJS). This condition is potentially life threatening because, in severe cases, the lesions can cause significant scarring of the involved organs, which often leads to loss of function of the organ systems.

The reaction typically starts with a nonspecific upper respiratory tract infection. During the first stage of SJS, patients may experience flu-like symptoms, including, fever, sore throat, chills, headache, and a general feeling of discomfort for one to 14 days. Some patients also develop diarrhea and vomiting. As the disease progresses, skin lesions quickly develop. Skin lesions may occur anywhere, but they are most common on the soles of the feet, palms of the hands, and back of the hands. The skin may become red, swollen, or blistered and may contain open sores and/or blisters. Patients may experience extensive shedding of the skin. Patients who experience symptoms of SJS should seek immediate medical treatment.

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