Gianotti-Crosti Syndrome: A Rare Presentation of the Influenza Virus

Abstract

Gianotti-Crosti Syndrome (GCS) is a benign, self-limited dermatologic condition that predominantly affects pediatric patients. It is most commonly associated with viral infections; however, reports implicating Influenza A virus (IAV) as an etiological agent are exceedingly rare. We report the case of a previously healthy two-year-old girl who presented with fever, rhinorrhea, and a symmetric papulovesicular rash involving the extremities, face, and trunk. Laboratory evaluation revealed leukopenia, neutropenia, and mildly elevated aspartate aminotransferase levels. Serological testing for Epstein-Barr virus (EBV), cytomegalovirus (CMV), and parvovirus B19 was negative, while antigen-based nasal swab testing confirmed the presence of IAV. Based on the characteristic clinical features and exclusion of other common causes, a diagnosis of GCS secondary to IAV infection was established. The patient received symptomatic treatment, and the rash resolved completely within 12 days, with no residual skin changes or complications. This case highlights a rare but clinically relevant association between IAV and GCS. Although cutaneous manifestations of IAV infection are uncommon, they should be considered in the differential diagnosis of GCS, particularly during influenza season. Prompt recognition of this condition is essential to avoid unnecessary investigations and to provide appropriate guidance and reassurance to caregivers.

Keywords: fever with rash; gianotti-crosti syndrome; influenza a virus; influenza virus type a; maculo-papular rash; rash in children.

Figure 1. Papular rash on the trunk compatible with Gianotti-Crosti syndrome

Figure 2. Papular rash compatible with Gianotti-Crosti syndrome, confluent over the knee