Abdominal Pain & Erythema Multiforme & Pharyngeal Hemorrhage: Causes & Reasons

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Patient File

Sex unknown, Age unknown

Reported Symptoms

Abdominal Pain, Erythema Multiforme, Pharyngeal Hemorrhage,

Negated

None

Unsure

None

Possible Causes

Infectious Mononucleosis

The hemorrhagic pharyngeal tonsils with hot signals on 18F-fluorodeoxyglucose-positron emission tomography-computed tomography were biopsied revealing the presence of EBV-encoded [ncbi.nlm.nih.gov]

multiforme Erythema nodosum Urticaria including cold urticaria Urticarial vasculitis Acrocyanosis (bluish hands and feet) Annular erythema Pityriasis lichenoides Palmar dermatitis [dermnetnz.org]

The evaluation of a febrile patient with acute abdominal pain represents a frequent yet possibly challenging situation in the emergency department (ED). [ncbi.nlm.nih.gov]

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Ulcerative Colitis

(n 1) Placebo (N 34): Total with adverse effects 5; vaginitis (n 1), edema (n 1), gastroenteritis (n 1), rectal hemorrhage (n 1), urinary tract infection (n 1), chest pain [doi.org]

Erythema multiforme is an immune-mediated cutaneous disorder that is thought to represent a hypersensitivity reaction to infections, drugs, vaccines, malignancies, autoimmune [ncbi.nlm.nih.gov]

Abdominal pain Other names Stomach ache, tummy ache, belly pain Abdominal pain can be characterized by the region it affects Specialty General surgery Causes Serious: Appendicitis [en.wikipedia.org]

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Stevens-Johnson Syndrome

These lesions rupture and ulcerate and become covered by gray-white membranes and a hemorrhagic crust. [aao.org]

Characteristic target lesions appeared at 72 h, and a diagnosis of erythema multiforme secondary to griseofulvin was made after further investigation and skin biopsy. [ncbi.nlm.nih.gov]

pain 7.5% Abnormality of the eyelid 7.5% Abnormality of the myocardium 7.5% Abnormality of the pleura 7.5% Abnormality of the preputium 7.5% Abnormality of the urethra 7.5% [web.archive.org]

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Lymphogranuloma Venereum

Certain serovars of causative agent may cause pharyngeal infection. [news-medical.net]

The skin may be affected by erythema multiforme, urticaria, erythema nodosum or scarlatiniform rash. [patient.info]

We present two young black women who suffered from chronic diarrhoea, abdominal pain and weight loss. [ncbi.nlm.nih.gov]

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Meningococcemia

Most people become carrier & develop no symptoms, except occasional pharyngitis. Stage-II: Characterized by septicemia. [histopathology-india.net]

multiforme Toxic shock syndrome Disseminated gonococcal infection Other causes of bacterial sepsis Meningitis Typhoid fever Q fever Typhus ( epidemic and endemic ) Fulminant [visualdx.com]

pain and vomiting. [nejm.org]

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Erythema Chronicum Migrans

Stroke Stroke, Hemorrhagic Temporal Arteritis Thoracic Aortic Dissection Upper Gastrointestinal Bleed Urinary Incontinence, Women Urinary Tract Infection, Child Urinary Tract [jamaevidence.mhmedical.com]

Synonym: erythema chronicum migrans See: Lyme disease for illus ERYTHEMA MULTIFORME erythema multiforme Abbreviation: EM A rash usually caused by an immune response to drugs [medical-dictionary.thefreedictionary.com]

nausea, vomiting, abdominal pain) Meningitis, focal neurological deficits Rapid clinical deterioration with shock and multi-organ dysfunction Confirmatory test Detection [amboss.com]

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Coxsackievirus Infection

[…] is characterized by firm, raised lesions, surrounded by a zone of erythema; Group A viruses are associated with aseptic meningitis, colds, acute hemorrhagic conjunctivitis [msdsonline.com]

One may assume that these were atypical forms of hand-foot-mouth disease or erythema exudativum multiforme associated with coxsackievirus A6 infection, as coxsackievirus A6 [medicaljournals.se]

pain caused by irritation of the pleura and muscles Coxsackie A and B Conjunctivitis Viral meningitis Flu‑like symptoms Coxsackie B is the most common cause of viral myocarditis [amboss.com]

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Acute Glomerulonephritis

Other signs Pharyngitis Impetigo Respiratory infection Pulmonary hemorrhage Heart murmur may indicate endocarditis Scarlet fever Weight gain Abdominal pain Anorexia Back pain [sites.google.com]

His third child had erythema multiforme and S. constellatus in the throat while a fourth child had beta-hemolytic streptococci group A; Streptococcus pyogenes. [ncbi.nlm.nih.gov]

pain Chronic Glomerulonephritis Prevention There is no known way to prevent chronic glomerulonephritis. [healthcommunities.com]

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Gingivostomatitis

Outbreaks can be associated with pharyngitis, fever, drooling (Clin Fam Pract 2003;5[3];589), malaise, and lymphadenopathy. [journals.lww.com]

Analgesics Treatment summary associated with acute problems of the oral mucosa (e.g. acute herpetic gingivostomatitis, erythema multiforme) may be relieved by... [evidence.nhs.uk]

Symptoms Some common symptoms are: Lower abdominal pain Abdominal tenderness Bruising at the site of injury Blood in the urine Bloody urethral discharge Difficulty beginning [mclarenhealthplan.org]

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Hantavirus Pulmonary Syndrome

Fever, often with shaking chills; severe polyarticular arthralgia; rash with headache, photophobia, retro-orbital pain, sore throat, pharyngitis, nausea, vomiting Arthralgia [nap.edu]

multiforme erythema nodosum esophageal stricture or corrosive esophagitis esophagus, cancer of exophthalmos (proptosis) extradural hemorrhage (epidural hemorrhage) eye contusion [healthse.com]

The second phase lasts 2 to 8 days and includes rapid development of fever, dry cough, body aches, headaches, diarrhea, and abdominal pain. [lung.org]

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Corynebacterium Diphtheriae

Abdominal pain • cachexia • diarrhea • fever • vomiting. -. Mitral valve replacement. Surgery. Rare disease. [ncbi.nlm.nih.gov]

The patient was a 35-year-old male drug addict who was brought to the hospital with fever, chills, and abdominal pain. [ncbi.nlm.nih.gov]

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Upper Gastrointestinal Bleeding

Severe Alcohol Withdrawal Syndrome Sexual Abuse, Child Shoulder Instability Sinusitis Sleep Apnea Splenomegaly Streptococcal Pharyngitis Stroke Stroke, Hemorrhagic Temporal [jamaevidence.mhmedical.com]

Melasma ( 19.3% ), Eczema or dermatitis ( 14.5%), Acne – form rash (12.9%), Folliculitis (9.7%), Erythema nodosum (6.4%), Erythema multiforme (4.8%), Pruritus ( 4.8%), Pityriasis [iasj.net]

Abdominal pain is the most common sign of gastrointestinal involvement. Gastrointestinal bleeding occurs less frequently in approximately 6% of cases. [ncbi.nlm.nih.gov]

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Anthrax

[…] in pharyngeal lesions with sore throat, dypshagia marked neck swelling and regional lymphadenopathy, or intestinal infection characterized by fever, severe abdominal pain [web.archive.org]

The latter presented with abdominal pain and distension, vomiting, and fever. Both cases were proven by animal inoculation. [ncbi.nlm.nih.gov]

In this case, severe abdominal pain occurred during the course of a stent placement procedure. [ncbi.nlm.nih.gov]

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Herpes Simplex Gingivostomatitis

Outbreaks can be associated with pharyngitis, fever, drooling ( Clin Fam Pract 2003;5[3];589), malaise, and lymphadenopathy. [journals.lww.com]

Recurrent erythema multiforme has been linked to a previous HSV infection, and is called herpes-associated erythema multiforme. [dentalresource.org]

Average of 5 lesions although some cases can have up to 16. in addition to fever and oral lesions, headache, vomiting, and abdominal pain may occur. [pedclerk.bsd.uchicago.edu]

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Acute Catarrhal Tonsillitis

Pharyngeal hemorrhages from the causes enumerated under the first of the foregoing divisions are rare. [operatingmicroscopes.com]

The skin biopsy gave results that were characteristic of erythema multiforme, supporting the initial clinical diagnosis and ruling out staphylococcal scalded skin syndrome [archbronconeumol.org]

pain of great severity associated with other symptoms and signs, usually those of acute peritonitis, which might well be the result of a ruptured abdominal viscus or a similar [kmle.co.kr]

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Renal Cortical Necrosis

streptococcus pharyngitis, [16] dehydration in infancy or childhood, organophosphorus poisoning [17] and intra-abdominal procedures. [18] In a study, overall, abruptio placenta [sjkdt.org]

[…] induratum 多形滲出性紅斑：erythema exudativum multiforme 天疱瘡：pemphigus 類天疱瘡：bullous pemphigoid 慢性単純性苔癬（ヴィダール苔癬）：lichen simplex chronicus 扁平苔癬：lichen planus 全身性エリテマトーデス：systemic [medical-e.net]

The patient presented with worsening symptoms consisting of arthralgias, pruritus, and abdominal pain. [ncbi.nlm.nih.gov]

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Nonallergic Interstitial Nephritis

Other signs Pharyngitis Impetigo Respiratory infection Pulmonary hemorrhage Heart murmur may indicate endocarditis Scarlet fever Weight gain Abdominal pain Anorexia Back pain [sites.google.com]

multiforme, exfoliative dermatitis, urticaria Frequency not reported : Ecchymosis, purpura, alopecia, photosensitivity, sweating [ Ref ] Hepatic Common (1% to 10%): Elevated [drugs.com]

Erythema multiforme (EM) consists of maculopapular eruptions and erythematous target lesions with central clearing. [thefreelibrary.com]

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Epidermolysis Bullosa Acquisita

Hemorrhagic blisters and petechiae were also present on the dorsum of the tongue and posterior pharyngeal wall, compounded with the additional complication of candidiasis [cdeworld.com]

We report a patient with a spectrum of clinical features simulating toxic epidermal necrolysis, bullous erythema multiforme and later, dermatitis herpetiformis (DH). [ncbi.nlm.nih.gov]

pain Pain in stomach Stomach pain [3] In some milder cases of EBA, the immune proteins involved are thought to be IgA, rather than IgG autoantibodies. [rarediseases.info.nih.gov]

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Acute Nephritis

This report reaffirms that acute hemorrhagic nephritis can be associated with pharyngitis caused by other than group A hemolytic streptococcus. [pediatrics.aappublications.org]

Secondary Causes of Nephrotic Syndrome Metabolic Amyloidosis Diabetes mellitus Immunologic Cryoglobulinemia Erythema multiforme Henoch-Schönlein purpura Microscopic polyangiitis [aafp.org]

We describe a patient with renal transplant who developed abdominal pain and acute nephritis in the course of the follow-up. [ncbi.nlm.nih.gov]

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Acute Respiratory Infection

48.   Viral: edema and hyperemia of tonsils and pharyngeal mucosa  Streptococcal: exudate and hemorrhage involving tonsils and pharyngeal walls  Epstein-Barr virus (infectious [slideshare.net]

Levamisole in the treatment of erythema multiforme: a double-blind trial in fourteen patients. [doi.org]

Abstract BACKGROUND: Gastrointestinal (GI) symptoms, such as diarrhea, vomiting, abdominal pain and nausea are not an uncommon manifestation of an acute respiratory infection [ncbi.nlm.nih.gov]

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Thickened Earlobes-Conductive Deafness Syndrome

THROAT : SOAR THROAT : Infection mononucleosis, strep-throat (streptococcal pharyngitis). [kumc.edu]

multiforme Erythermalgia Erythroblastopenia Erythroderma desquamativa of Leiner Erythroderma lethal congenital Erythrokeratodermia ataxia Erythrokeratodermia progressive [bioreference.net]

Erysipelas Erythema multiforme[?] Erythermalgia[?] Erythroblastopenia[?] Erythroderma desquamativa of Leiner[?] Erythroderma lethal congenital[?] [encyclopedia.kids.net.au]

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Cat Scratch Meningoencephalitis

rash, or GI signs possible; biphasic or triphasic in some; complications (eg, neurologic signs, hemorrhages, pericarditis, myocarditis, orchitis) uncommon but can occur [merckvetmanual.com]

[…] nodosum, erythema multiforme), lungs, and bones (arthritis and osteomyelitis). [emedicine.medscape.com]

[…] lymph nodes; painful purulent conjunctivitis; abdominal pain; diarrhea; vomiting; chest pain; respiratory distress; pneumonia; sepsis; death ANIMAL Disease Species With Zoonotic [borrettanimalhospital.com]

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Impetigo

In addition to findings of exudative pharyngitis and tonsillitis, patients display an exanthem that is characterized by small, red, hemorrhagic spots on the hard and soft [ncbi.nlm.nih.gov]

multiforme Bullous mastocytosis Varicella Sneddon-Wilkinson subcorneal pustulosis Best Tests Subscription Required Management Pearls Subscription Required Therapy Subscription [visualdx.com]

pain 1/ 31, vomiting 2/31 Barton 1987 not reported Barton 1988 abdominal pain: erythromycin 1/ 49, dicloxacillin 1/51 vomiting rash: dicloxacillin 1/51 Barton 1989 gastrointestinal [doi.org]

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Hyperglobulinemic Purpura

[…] skin necrosis is characteristic Usually follows some acute infectious disease such as scarlet fever, strep pharyngitis, and meningococcal meningitis, varicella. 46 Purpura [slideplayer.com]

Causes of Palpable purpura Note: Image search may contain inaccuracies Churg-Strauss syndrome Cryoglobulinaemia Erythema multiforme Henoch-Schoenlein purpura Leukocytoclastic [xdiagnosis.net]

In both abdominal pain and gastrointestinal bleeding there can be cutaneous findings that suggest the underlying cause. [accessmedicine.mhmedical.com]

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Conjunctivitis

Adenoviral Herpetic Watery discharge bilaterally Usually unilateral watery discharge Hyperaemia Diffuse hyperaemia Petechial hemorrhages Vesicular eruptions on eyelid Punctate [intechopen.com]

A severe form of conjunctivitis that may culminate in blindness occasionally accompanies erythema multiforme, an eruption on the skin and mucous membranes that sometimes occurs [britannica.com]

pain, dyspepsia, right upper vomiting quadrant pain Hepatobiliary disorders Skin and Alopecia, pruritus, Sweating increased subcutaneous skin dry, rash tissue disorders Last [mymemory.translated.net]

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Acute Subglottic Laryngitis

Signs And Symptoms Hemorrhage (morphologic abnormality) Organ Affected Pharyngeal structure (body structure) Structure of anterior portion of neck (body structure) Entire [medicbind.com]

multiforme, Stevens-Johnson syndrome, erythema nodosum Fever and its treatment strategy Fever of unknown origin - FUO (etiology and work-up) Differential diagnosis of febrile [wikilectures.eu]

pain, peripheral non pitting oedema, laryngeal oedema 28. [slideshare.net]

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Enterovirus Infection

Clinical Manifestations can include the following: respiratory -- common cold, pharyngitis, herpangina, stomatitis, pneumonia, and pleurodynia skin --exanthem neurologic-- [meddean.luc.edu]

Other cutaneous features are sometimes seen in enterovirus infections and include: Pustular stomatitis with erythema multiforme : caused by CVB5 Widespread vesicular eruption [dermnetnz.org]

pain, and suggest a possible association between enteroviruses and tumorigenesis. [ncbi.nlm.nih.gov]

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Post Viral Asthenia

10% or more): Upper respiratory infection (26.9%), cough (11%) Common (1% to 10%): Rhinorrhea Uncommon (0.1% to 1%): Nasal congestion, respiratory congestion, influenza, pharyngitis [drugs.com]

There are respiratory and intestinal symptoms with sore throat, cough, nausea, vomiting, and abdominal pain. [orange.mu]

Other symptoms may include nausea, fever, abdominal pain, headache, and muscle aches. Dehydration can follow. [health.nsw.gov.au]

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Gonococcemia

Khanna 10 10 Can pharyngeal gonorrhea be spread by kissing? Dr. Yash Khanna Dr. [healthtap.com]

Differential diagnosis: Viral exanthems Hypersensitivity vasculitis Drug reaction with esosinophila and systemic symptoms (DRESS) Erythema multiforme SJS Sweet syndrome Reactive [sinaiem.org]

A 15-year-old boy with a family history of renal disease, presents with hematuria and lower abdominal pain, as his third episode in the past 2 years.His BP:145/90mmHg,HR:80 [coursehero.com]

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Coxsackie Meningitis

[…] disease (A10, A16), pneumonitis of infants, “common cold”, hepatitis, infantile diarrhoea, acute hemorrhagic conjunctivitis (A24) Footnote 1 Footnote 5. [canada.ca]

Coxsackievirus B5 causes pustular stomatitis with erythema multiforme. Coxsackievirus A4 causes a widespread vesicular eruption. [patient.info]

Coxsackie virus es cause sore throat or fever with chest or abdominal pains. [britannica.com]

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