The differential diagnosis of rubella is of importance for two reasons: first, to distinguish it from toxic rashes and thus prevent the spread of the disease and, second, to distinguish it from scarlet fever and measles and thus permit the care necessary in these more serious conditions. Rubella is usually considered a benign disease. Deaths, however, occur. Carrieu, Lamy and Bouchet1 reported two fatal cases in young children. Belson2 stated that from 1914 through 1929 there were 26 deaths in 35,879 cases reported in Massachusetts.
Complications are rare, but may be serious. Geiger3 described an epidemic in which arthritis was frequent; otitis media, acute nephritis and endocarditis also were observed. Severe symptomatic purpura haemorrhagica with recovery has been described by Pitten4 and Gunn.5 Suppuration of the cervical lymph nodes, bronchitis and epistaxis occurred in the epidemic reported by Carrieu, Lamy and Bouchet. Involvement of joints,