Key takeaways: Many viral illnesses cause fever and rash, and most are harmless. A rash of tiny purple or red dots (petechiae) or larger bruise-like spots (purpura) that don’t fade when pressed, along with fever, can be a sign of a serious infection and needs emergency care. Any fever in a baby under 3 months needs a call to the doctor.
Fever and rash together are common in babies. Most are caused by viruses, but some combinations need fast care.
Common, Usually Harmless Causes
- Roseola: rash after several days of fever.
- Hand, foot, and mouth disease.
- Other viral rashes: blotchy pink rashes that fade when pressed.
Rashes That Need Urgent Care
- Petechiae or purpura: tiny pinpoint red or purple dots, or larger bruise-like patches, that don’t fade when pressed. With fever, this can be a sign of meningococcal infection or other serious illness.
- Rash with a very sick-looking baby.
- Blistering or peeling skin.
- Rash with swelling of the face, lips, or tongue, or trouble breathing (possible allergic reaction).
- Measles: fever, cough, red eyes, then rash.
The Glass Test
Press a clear glass firmly against the rash. If the spots don’t fade and you can still see them through the glass, get emergency care. Note: the glass test is a helpful clue but doesn’t replace a medical exam. If your baby seems very ill, seek care even if the rash fades.
Kawasaki Disease
Fever for 5 or more days with rash, red eyes, red lips, swollen hands or feet, or swollen neck glands needs prompt evaluation.
Seek emergency care or call 911 if your baby: has fever with a rash that doesn’t fade when pressed, is very sleepy or hard to wake, has trouble breathing, has a stiff neck, or seems very unwell. Call your doctor right away for any fever of 100.4°F or higher in a baby under 3 months.
The Bottom Line
Most fever rashes are viral and harmless. A non-fading rash or a very ill baby needs emergency care.
Want more support for your baby’s first year? My book, From First Breath to First Birthday, is available on Amazon.
Sources
- American Academy of Pediatrics. Rashes and fever. HealthyChildren.org. https://www.healthychildren.org
- Centers for Disease Control and Prevention. Meningococcal disease: symptoms. https://www.cdc.gov/meningococcal
- National Institute for Health and Care Excellence. Fever in under 5s: assessment and initial management (NG143). 2019. https://www.nice.org.uk/guidance/ng143
This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.
