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Am J Dis Child. 1924;27(6):598-602. doi:10.1001/archpedi.1924.01920120060009.
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The skin lesions in acute infectious diseases are among the important and most easily determined clinical findings. Their cause, in some instances, has been explained on the basis of the presence of toxic substances, and in other instances it has been shown positively to be due to the presence of microorganisms. The hemorrhagic, purpuric and petechial lesions belong especially to this latter group. The demonstration of typhoid bacilli in the "rose spots," of streptococci in the skin lesions associated with streptococcus septicemia and subacute bacterial endocarditis, of tubercle bacilli in the petechiae or tuberculids seen in acute miliary tuberculosis, are the most striking examples of this type of etiology.

The meningococcemia preceding or associated with acute epidemic cerebrospinal meningitis is manifest in some cases by the appearance of skin lesions of a petechial or purpuric nature. This characteristic has gained the terms "spotted fever," "black fever" and "petechial fever" for


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