{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T04:31:54Z","timestamp":1772253114382,"version":"3.50.1"},"reference-count":80,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T00:00:00Z","timestamp":1652054400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP19m0108003"],"award-info":[{"award-number":["JP19m0108003"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["21wm0225010h0102"],"award-info":[{"award-number":["21wm0225010h0102"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Osaka University ASEAN campus project and the International Postdoctoral Fellowship 2021","award":["JP19m0108003"],"award-info":[{"award-number":["JP19m0108003"]}]},{"name":"Osaka University ASEAN campus project and the International Postdoctoral Fellowship 2021","award":["21wm0225010h0102"],"award-info":[{"award-number":["21wm0225010h0102"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Fever and rash as manifestations of infection by microorganisms are collectively known as febrile exanthem. Since viruses are more frequently associated with fever and rash, these symptoms are thus impetuously termed viral exanthem. However, bacteria represent a frequently overlooked infectious etiology causing rash in humans. In addition, certain microbes may exhibit pathognomonic features that erupt during illness and facilitate clinical diagnosis. Conversely, coinfections often obscure the clinical characteristics of the primary disease and further challenge clinicians attempting to reach a diagnosis. We retrospectively looked at de-identified clinical data of a patient who presented to the Hospital for Tropical Diseases in Bangkok in July 2019 with complaints of fever and rash. The case involved a 35-year-old who presented with a 3-day history of fever, respiratory symptoms, myalgia, conjunctivitis, diarrhea, and a generalized maculopapular rash. On examination, the patient was febrile, tachycardic, and tachypneic, with a mean arterial pressure of 95 mmHg. A differential white blood cell count showed: leukocytes, 5800\/\u00b5L; neutrophils, 4408\/\u00b5L; lymphocytes, 406\/\u00b5L; and platelets, 155,000\/\u00b5L. Striking findings involving the integumentary system included Koplik\u2019s spots and generalized maculopapular rash. Further serology revealed positive immunoglobulin (Ig)M and IgG for both measles and rubella virus, including reactive serology for Treponema pallidum. Here we describe the clinical course and management of this patient.<\/jats:p>","DOI":"10.3390\/tropicalmed7050070","type":"journal-article","created":{"date-parts":[[2022,5,10]],"date-time":"2022-05-10T21:52:11Z","timestamp":1652219531000},"page":"70","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A Case Report of Secondary Syphilis Co-Infected with Measles: A Diagnostic Dilemma with Fever and Rash"],"prefix":"10.3390","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4812-6334","authenticated-orcid":false,"given":"Hisham Ahmed","family":"Imad","sequence":"first","affiliation":[{"name":"Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand"},{"name":"Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand"},{"name":"Center for Infectious Disease Education and Research, Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, Suita 565-0871, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ploi","family":"Lakanavisid","sequence":"additional","affiliation":[{"name":"Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand"},{"name":"Department of Preventive Medicine and Family Medicine, Faculty of Medicine, Burapha University, Chonburi 20130, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phimphan","family":"Pisutsan","sequence":"additional","affiliation":[{"name":"Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand"},{"name":"Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kentaro","family":"Trerattanavong","sequence":"additional","affiliation":[{"name":"Hull York Medical School, University Road, Heslington, York, YO10 5DD, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1602-5435","authenticated-orcid":false,"given":"Thundon","family":"Ngamprasertchai","sequence":"additional","affiliation":[{"name":"Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand"},{"name":"Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7165-2765","authenticated-orcid":false,"given":"Wasin","family":"Matsee","sequence":"additional","affiliation":[{"name":"Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand"},{"name":"Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Watcharapong","family":"Piyaphanee","sequence":"additional","affiliation":[{"name":"Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand"},{"name":"Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6215-8290","authenticated-orcid":false,"given":"Pornsawan","family":"Leaungwutiwong","sequence":"additional","affiliation":[{"name":"Tropical Medicine Diagnostic Reference Laboratory, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand"},{"name":"Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5484-7130","authenticated-orcid":false,"given":"Wang","family":"Nguitragool","sequence":"additional","affiliation":[{"name":"Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand"},{"name":"Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0477-0980","authenticated-orcid":false,"given":"Emi E.","family":"Nakayama","sequence":"additional","affiliation":[{"name":"Center for Infectious Disease Education and Research, Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, Suita 565-0871, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3439-8331","authenticated-orcid":false,"given":"Tatsuo","family":"Shioda","sequence":"additional","affiliation":[{"name":"Center for Infectious Disease Education and Research, Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, Suita 565-0871, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,9]]},"reference":[{"key":"ref_1","first-page":"804","article-title":"Evaluating the febrile patient with a rash","volume":"62","author":"McKinnon","year":"2000","journal-title":"Am. Fam. Physician"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"155","DOI":"10.3947\/ic.2015.47.3.155","article-title":"Febrile Illness with Skin Rashes","volume":"47","author":"Kang","year":"2015","journal-title":"Infect. Chemother."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"171","DOI":"10.2217\/fmb-2016-0147","article-title":"Contemporary infectious exanthems: An update","volume":"12","author":"Drago","year":"2017","journal-title":"Future Microbiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"420","DOI":"10.5021\/ad.2012.24.4.420","article-title":"Clinical Features and Etiology of Adult Patients with Fever and Rash","volume":"24","author":"Tabak","year":"2012","journal-title":"Ann. Dermatol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Wanlapakorn, N., Wasitthankasem, R., Vichaiwattana, P., Auphimai, C., Yoocharoen, P., Vongpunsawad, S., and Poovorawan, Y. (2019). Antibodies against measles and rubella virus among different age groups in Thailand: A population-based serological survey. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0225606"},{"key":"ref_6","unstructured":"Centers for Disease Control and Prevention (2013). HIV and syphilis infection among men who have sex with men--Bangkok, Thailand, 2005\u20132011. MMWR Morb. Mortal. Wkly. Rep., 60, 518\u2013520."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"6","DOI":"10.4103\/ijpvm.IJPVM_216_17","article-title":"First report of a disease by rhazes 10 centuries ago","volume":"10","author":"Parsian","year":"2019","journal-title":"Int. J. Prev. Med."},{"key":"ref_8","first-page":"E277","article-title":"Measles with a possible 23 day incubation period","volume":"36","author":"Fitzgerald","year":"2012","journal-title":"Commun. Dis. Intell. Q. Rep."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Laksono, B.M., De Vries, R.D., McQuaid, S., Duprex, W.P., and De Swart, R.L. (2016). Measles Virus Host Invasion and Pathogenesis. Viruses, 8.","DOI":"10.3390\/v8080210"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"S4","DOI":"10.1086\/377712","article-title":"The Clinical Significance of Measles: A Review","volume":"189","author":"Perry","year":"2004","journal-title":"J. Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1136\/postgradmedj-2019-136739","article-title":"Koplik spots in measles","volume":"95","author":"Tanaka","year":"2019","journal-title":"Postgrad. Med J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1177\/000992287201100308","article-title":"Koplik spots for the record: An illustrated historical note","volume":"11","author":"Brem","year":"1972","journal-title":"Clin. Pediatr."},{"key":"ref_13","first-page":"512","article-title":"Measles: A disease often forgotten but not gone","volume":"24","author":"Leung","year":"2018","journal-title":"Hong Kong Med. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"20210153","DOI":"10.1098\/rsif.2021.0153","article-title":"Immune amnesia induced by measles and its effects on concurrent epidemics","volume":"18","author":"Morales","year":"2021","journal-title":"J. R. Soc. Interface"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1126\/science.aaa3662","article-title":"Long-term measles-induced immunomodulation increases overall childhood infectious disease mortality","volume":"348","author":"Mina","year":"2015","journal-title":"Science"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.spen.2012.02.003","article-title":"Measles Virus and Associated Central Nervous System Sequelae","volume":"19","author":"Buchanan","year":"2012","journal-title":"Semin. Pediatr. Neurol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"177","DOI":"10.33073\/pjm-2020-020","article-title":"The Resurgence of Measles Infection and its Associated Complications in Early Childhood at a Tertiary Care Hospital in Peshawar, Pakistan","volume":"69","author":"Ilyas","year":"2020","journal-title":"Pol. J. Microbiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1007\/s11910-020-1023-y","article-title":"Neurological Complications of Measles (Rubeola)","volume":"20","author":"Patterson","year":"2020","journal-title":"Curr. Neurol. Neurosci. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"48","DOI":"10.4038\/cmj.v46i2.6491","article-title":"Neurological complications of measles","volume":"46","author":"Gunaratne","year":"2014","journal-title":"Ceylon Med. J."},{"key":"ref_20","first-page":"221","article-title":"Complications and Sequelae of Measles","volume":"2","author":"Mayer","year":"1904","journal-title":"Calif. State J. Med."},{"key":"ref_21","first-page":"14","article-title":"Clinical outcome in measles patients hospitalized with complications","volume":"20","author":"Idris","year":"2008","journal-title":"J. Ayub Med. Coll. Abbottabad"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"104608","DOI":"10.1016\/j.jcv.2020.104608","article-title":"Clinical characteristics and outcomes of measles outbreak in adults: A multicenter retrospective observational study of 93 hospitalized adults in Greece","volume":"131","author":"Fragkou","year":"2020","journal-title":"J. Clin. Virol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1001\/jamadermatol.2017.0771","article-title":"Al Rhazes and the Beginning of the End of Smallpox","volume":"153","author":"Band","year":"2017","journal-title":"JAMA Dermatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1071\/SH14174","article-title":"Syphilis transmission: A review of the current evidence","volume":"12","author":"Stoltey","year":"2015","journal-title":"Sex. Health"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1097\/00007435-199704000-00002","article-title":"The natural history of syphilis. Implications for the transmission dynamics and control of infection","volume":"24","author":"Garnett","year":"1997","journal-title":"Sex. Transm. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1111\/j.1365-2133.1975.tb06476.x","article-title":"Secondary syphilis: A clinico-pathological review","volume":"93","author":"Abell","year":"1975","journal-title":"Br. J. Dermatol."},{"key":"ref_27","first-page":"32","article-title":"Is dark-field microscopy still useful for the primary syphilis diagnosis in the 21ST century?","volume":"40","year":"2022","journal-title":"Enferm. Infecc. Y Microbiol. Clin."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1128\/CMR.8.1.1","article-title":"Laboratory diagnosis and interpretation of tests for syphilis","volume":"8","author":"Larsen","year":"1995","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/S0732-8893(01)00275-9","article-title":"Amplification of the DNA polymerase I gene of Treponema pallidum from whole blood of persons with syphilis","volume":"40","author":"Marfin","year":"2001","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1159\/000076479","article-title":"Detection of Treponema pallidum in skin lesions of secondary syphilis and characterization of the inflammatory infiltrate","volume":"208","author":"Wenhai","year":"2004","journal-title":"Dermatology"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"339","DOI":"10.4103\/IJPM.IJPM_188_18","article-title":"Cervical syphilitic lymphadenitis causing fever of unknown origin followed by rash of secondary syphilis","volume":"62","author":"Psevdos","year":"2019","journal-title":"Indian J. Pathol. Microbiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1503\/cmaj.060665","article-title":"The rash of secondary syphilis","volume":"176","author":"Dylewski","year":"2006","journal-title":"Can. Med. Assoc. J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1128\/CMR.18.1.205-216.2005","article-title":"Secondary Syphilitic Lesions","volume":"18","author":"Baughn","year":"2005","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1097\/00007435-198010000-00002","article-title":"The Signs and Symptoms of Secondary Syphilis","volume":"7","author":"Chapel","year":"1980","journal-title":"Sex. Transm. Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"m4450","DOI":"10.1136\/bmj.m4450","article-title":"Measles cases and deaths are increasing worldwide, warn health agencies","volume":"371","author":"Tanne","year":"2020","journal-title":"BMJ"},{"key":"ref_36","first-page":"1178633719883282","article-title":"Resurgence of Syphilis in the United States: An Assessment of Contributing Factors","volume":"12","author":"Schmidt","year":"2019","journal-title":"Infect. Dis. Res. Treat."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1038\/s41598-020-80214-3","article-title":"Factors associated with measles resurgence in the United States in the post-elimination era","volume":"11","author":"Dimala","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Abara, W.E., Hess, K.L., Neblett Fanfair, R., Bernstein, K.T., and Paz-Bailey, G. (2016). Syphilis Trends among Men Who Have Sex with Men in the United States and Western Europe: A Systematic Review of Trend Studies Published between 2004 and 2015. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0159309"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1258\/095646207780132433","article-title":"Patterns of HIV and syphilis infection in Northern Thailand 1998\u20132001","volume":"18","author":"Beyrer","year":"2007","journal-title":"Int. J. STD AIDS"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1177\/09564624211048774","article-title":"Incidence of syphilis infection and syphilis-related care utilization among adolescents and young adults living with HIV","volume":"33","author":"Bonett","year":"2021","journal-title":"Int. J. STD AIDS"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1136\/sti.2003.007500","article-title":"HIV, syphilis infection, and sexual practices among transgenders, male sex workers, and other men who have sex with men in Jakarta, Indonesia","volume":"80","author":"Pisani","year":"2004","journal-title":"Sex. Transm. Infect."},{"key":"ref_42","first-page":"9","article-title":"HIV and syphilis coinfection: Trends and interactions","volume":"15","author":"Kassutto","year":"2003","journal-title":"AIDS Clin. Care"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"622","DOI":"10.4269\/ajtmh.18-0407","article-title":"Etiologies of Acute Undifferentiated Febrile Illness in Bangkok, Thailand","volume":"100","author":"Luvira","year":"2019","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Imad, H., Matsee, W., Kludkleeb, S., Asawapaithulsert, P., Phadungsombat, J., Nakayama, E., Suzuki, K., Leaungwutiwong, P., Piyaphanee, W., and Phumratanaprapin, W. (2021). Post\u2013Chikungunya Virus Infection Musculoskeletal Disorders: Syndromic Sequelae after an Outbreak. Trop. Med. Infect. Dis., 6.","DOI":"10.20944\/preprints202103.0680.v1"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.tmaid.2018.05.010","article-title":"Fever, rash, and red eyes in Thailand: A diagnostic challenge","volume":"24","author":"Imad","year":"2018","journal-title":"Travel Med. Infect. Dis."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"532","DOI":"10.3201\/eid2203.151607","article-title":"Signs or Symptoms of Acute HIV Infection in a Cohort Undergoing Community-Based Screening","volume":"22","author":"Hoenigl","year":"2016","journal-title":"Emerg. Infect. Dis."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1067\/mai.2002.125978","article-title":"HIV: Clinical manifestations","volume":"110","author":"Moylett","year":"2002","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Posuwan, N., Wanlapakorn, N., Sa-Nguanmoo, P., Wasitthankasem, R., Vichaiwattana, P., Klinfueng, S., and Poovorawan, Y. (2016). The success of a universal hepatitis B immunization program as part of Thailand\u2019s EPI after 22 years\u2019 implementation. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0150499"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/S1068-607X(01)00072-5","article-title":"Rubella","volume":"8","author":"Signore","year":"2001","journal-title":"Prim. Care Update Ob\/Gyns"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1001\/archinte.1989.00390050111022","article-title":"Clinical manifestations of human parvovirus B19 in adults","volume":"149","author":"Woolf","year":"1989","journal-title":"Arch. Intern. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/S0889-857X(21)00846-2","article-title":"Rubella virus and arthritis","volume":"13","author":"Smith","year":"1987","journal-title":"Rheum. Dis. Clin. N. Am."},{"key":"ref_52","first-page":"14","article-title":"Rubella (German measles)--still a major infectious disease","volume":"35","author":"Stock","year":"2012","journal-title":"Med. Mon. Fur Pharm."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Imad, H., Phadungsombat, J., Nakayama, E., Kludkleeb, S., Matsee, W., Ponam, T., Suzuki, K., Leaungwutiwong, P., Piyaphanee, W., and Phumratanaprapin, W. (2021). Chikungunya Manifestations and Viremia in Patients WhoPresented to the Fever Clinic at Bangkok Hospital for Tropical Diseases during the 2019 Outbreak in Thailand. Trop. Med. Infect. Dis., 6.","DOI":"10.3390\/tropicalmed6010012"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1016\/S0190-9622(08)80888-2","article-title":"Koplik spots and a purpuric eruption associated with parvovirus B19 infection","volume":"27","author":"Evans","year":"1992","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"269","DOI":"10.3389\/fmicb.2019.00269","article-title":"The Association Between Documentation of Koplik Spots and Laboratory Diagnosis of Measles and Other Rash Diseases in a National Measles Surveillance Program in Japan","volume":"10","author":"Kimura","year":"2019","journal-title":"Front. Microbiol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1093\/clinids\/21.4.1060","article-title":"Severe Measles Pneumonitis in Adults","volume":"21","author":"Gubler","year":"1995","journal-title":"Clin. Infect. Dis."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1093\/clinids\/21.2.443","article-title":"Clinical Course and Treatment of Adults with Severe Measles Pneumonitis","volume":"21","author":"Goetz","year":"1995","journal-title":"Clin. Infect. Dis."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1172\/JCI13603","article-title":"Measles virus infection results in suppression of both innate and adaptive immune responses to secondary bacterial infection","volume":"111","author":"Slifka","year":"2003","journal-title":"J. Clin. Investig."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"141","DOI":"10.52964\/AMJA.0766","article-title":"Fever increases heart rate and respiratory rate; a prospective observational study of acutely admitted medical patients","volume":"18","author":"Jensen","year":"2019","journal-title":"Acute Med."},{"key":"ref_60","first-page":"637","article-title":"Measles-related hospitalizations and associated complications in Jerusalem, 2018\u20132019","volume":"26","author":"Oster","year":"2019","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_61","first-page":"905","article-title":"The Visceral Lesions in Measles: With a Report of Koplik Spots in the Colon","volume":"21","author":"Corbett","year":"1945","journal-title":"Am. J. Pathol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1080\/00365540110027259","article-title":"Measles-associated appendicitis: Two case reports and literature review","volume":"33","author":"Pancharoen","year":"2001","journal-title":"Scand. J. Infect. Dis."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"505","DOI":"10.34172\/aim.2021.72","article-title":"Acute Acalculous Cholecystitis after Measles","volume":"24","year":"2021","journal-title":"Arch. Iran. Med."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1016\/S0140-6736(85)92647-9","article-title":"Cross-reactions in rubella and parvovirus specific IgM tests","volume":"326","author":"Kurtz","year":"1985","journal-title":"Lancet"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1136\/jcp.31.5.483","article-title":"IgM-class rheumatoid factor interference in the solid-phase radioimmunoassay of rubella-specific IgM antibodies","volume":"31","author":"Meurman","year":"1978","journal-title":"J. Clin. Pathol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"2297","DOI":"10.1016\/S0140-6736(14)60539-0","article-title":"Rubella","volume":"385","author":"Lambert","year":"2015","journal-title":"Lancet"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Miqdhaadh, A., Imad, H.A., Fazeena, A., Ngamprasertchai, T., Nguitragool, W., Nakayama, E.E., and Shioda, T. (2021). Multisystem Inflammatory Syndrome Associated with SARS-CoV-2 Infection in an Adult: A Case Report from the Maldives. Trop. Med. Infect. Dis., 6.","DOI":"10.3390\/tropicalmed6040187"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1007\/s11606-017-4017-y","article-title":"Purpura Fulminans in Acute Meningococcemia","volume":"32","author":"Pitukweerakul","year":"2017","journal-title":"J. Gen. Intern. Med."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"567","DOI":"10.2169\/internalmedicine.55.3272","article-title":"Meningococcemia in Adults: A Review of the Literature","volume":"55","author":"Takada","year":"2016","journal-title":"Intern. Med."},{"key":"ref_70","first-page":"708","article-title":"Epidemiology of invasive meningococcal disease in 13 government hospitals in Thailand, 1994\u20131999","volume":"31","author":"Pancharoen","year":"2000","journal-title":"Southeast Asian J. Trop. Med. Public Health"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"535","DOI":"10.4269\/ajtmh.2001.65.535","article-title":"Short report: Thai tick typhus, Rickettsia honei, and a unique rickettsia detected in Ixodes granulatus (Ixodidae: Acari) from Thailand","volume":"65","author":"Kollars","year":"2001","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"592","DOI":"10.3201\/eid0905.020511","article-title":"Emerging rickettsioses of the Thai-Myanmar border","volume":"9","author":"Parola","year":"2003","journal-title":"Emerg. Infect. Dis."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1056\/NEJM197103252841205","article-title":"Diagnosis and treatment of syphilis","volume":"284","author":"Sparling","year":"1971","journal-title":"N. Engl. J. Med."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1093\/cid\/ciu325","article-title":"Incidence and Risk Factors for the Prozone Phenomenon in Serologic Testing for Syphilis in a Large Cohort","volume":"59","author":"Liu","year":"2014","journal-title":"Clin. Infect. Dis."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1503\/cmaj.120229","article-title":"Moth-eaten alopecia: A sign of secondary syphilis","volume":"185","author":"Qiao","year":"2012","journal-title":"Can. Med. Assoc. J."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.jdcr.2021.01.025","article-title":"Condyloma lata in secondary syphilis","volume":"10","author":"Pourang","year":"2021","journal-title":"JAAD Case Rep."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1001\/jama.2021.23487","article-title":"Diagnosis and Treatment of Sexually Transmitted Infections: A Review","volume":"327","author":"Tuddenham","year":"2022","journal-title":"JAMA"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"S127","DOI":"10.1093\/cid\/ciac060","article-title":"Management of Adult Syphilis: Key Questions to Inform the 2021 Centers for Disease Control and Prevention Sexually Transmitted Infections Treatment Guidelines","volume":"74","author":"Tuddenham","year":"2022","journal-title":"Clin. Infect. Dis."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1590\/0037-8682-0419-2017","article-title":"Jarisch-Herxheimer reaction in a patient with syphilis and human immunodeficiency virus infection","volume":"51","author":"Rodrigues","year":"2018","journal-title":"Rev. Da Soc. Bras. De Med. Trop."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"46","DOI":"10.4269\/ajtmh.16-0434","article-title":"The Jarisch\u2013Herxheimer Reaction After Antibiotic Treatment of Spirochetal Infections: A Review of Recent Cases and Our Understanding of Pathogenesis","volume":"96","author":"Butler","year":"2016","journal-title":"Am. J. Trop. Med. Hyg."}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/7\/5\/70\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:08:06Z","timestamp":1760137686000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/7\/5\/70"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,9]]},"references-count":80,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,5]]}},"alternative-id":["tropicalmed7050070"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed7050070","relation":{"has-preprint":[{"id-type":"doi","id":"10.20944\/preprints202204.0071.v1","asserted-by":"object"}]},"ISSN":["2414-6366"],"issn-type":[{"value":"2414-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,9]]}}}