Viral Illness Manifestations

Adenovirus

Upper respiratory infection, pharyngitis, conjunctivitis, pharyngoconjunctival fever, gastroenteritis, hemorrhagic cystitis, and keratoconjunctivitis

RSV (Infants/Young Children)

Rhinorrhea, congestion, fever, cough, wheezing, crackles, tachypnea, increased work of breathing, and potential respiratory distress or apnea

RSV (Adults)

Mild upper respiratory illness or exacerbations of asthma, COPD, or heart failure

HPV (Cutaneous Warts)

Rough hyperkeratotic papules, smooth flat-topped papules, or painful papules on weight-bearing surfaces that interrupt normal skin lines

HPV (Anogenital Warts)

Flesh-colored or pink papules in verrucous or cauliflower-like clusters on the external genitalia and perianal region

HSV-1 (Orolabial)

Primary gingivostomatitis with painful oral vesicles, ulcers, and lymphadenopathy or recurrent herpes labialis preceded by prodromal tingling

HSV-1 (Ocular/Neurologic)

Painful red eye with dendritic corneal ulcers or temporal lobe encephalitis with fever, altered mental status, and seizures

HSV-2

Painful, grouped vesicles on an erythematous base that rupture into shallow ulcers, potentially accompanied by fever, malaise, and tender inguinal lymphadenopathy during primary infection

Varicella (Chickenpox)

Pruritic vesicular rash classically described as "dewdrop on a rose petal"

Herpes Zoster (Shingles)

Unilateral painful grouped vesicles involving 1–2 adjacent dermatomes that typically do not cross the midline

Epstein-Barr virus (EBV) (Infectious Mononucleosis)

Profound fatigue, fever, pharyngitis with tonsillar exudates, posterior cervical lymphadenopathy, palatal petechiae, and splenomegaly

Cytomegalovirus/ CMV (Infectious Mononucleosis)

Mononucleosis-like illness with fever, fatigue, and malaise but less prominent pharyngitis and cervical lymphadenopathy than EBV

Cytomegalovirus/ CMV (End-Organ/Congenital)

Retinitis, esophagitis, or colitis in immunocompromised patients; "blueberry muffin" rash, microcephaly, intracranial calcifications, and hearing loss in congenital cases

Roseola (Sixth Disease)

Abrupt high fever for 3–5 days followed by the appearance of a blanching maculopapular rash on the trunk as the fever resolves

Erythema Infectiosum (Fifth Disease)

Bright red "slapped-cheek" rash followed by a lacy reticular rash on the trunk and extremities

Measles (Rubeola)

High fever and the "3 C's" (cough, coryza, conjunctivitis) followed by Koplik spots and a cephalocaudal maculopapular rash

Parainfluenza Virus (Croup)

Barking seal-like cough, inspiratory stridor, and hoarseness

Rubella (German Measles)

Mild fever, posterior auricular/cervical lymphadenopathy, and a fine pink maculopapular rash that lasts approximately 3 days

Mumps

Tender parotitis causing a "chipmunk cheek" appearance, potentially followed by orchitis with acute testicular pain and swelling

Rotavirus

Fever and vomiting followed by profuse watery non-bloody diarrhea

Norovirus

Abrupt onset of nausea, vomiting, and watery non-bloody diarrhea accompanied by abdominal cramps

Rabies

Pain or paresthesia at the bite site followed by progressive encephalitis including agitation, hydrophobia, aerophobia, and hypersalivation

Poliomyelitis

Mostly asymptomatic or minor febrile illness; rarely acute asymmetric flaccid weakness or paralysis with preserved sensation

Zika Virus

Low-grade fever, maculopapular rash, arthralgia, and nonpurulent conjunctivitis