Welcome to this month’s What’s Your Diagnosis Challenge!
But before we begin, check to see if you got the previous case on Management of Pediatric Febrile Seizures in the Emergency Department correct.
Case Presentation: Emergency Department Management of Measles, Mumps, Rubella, and Varicella in Pediatric Patients
A mother brings in her 3-month-old son, who has been fussy and has had a runny nose, cough, and fever for the past 5 days…
- The mother also tells you that the infant developed a red, raised rash on his face that spread to his abdomen and extremities over the course of a day. The mother reports that her son is eating less and has been breathing rapidly. The boy was born full-term in the United States and has no past medical history. He has had 1 vaccination visit at his primary care physician, at 2 months of age.
- The infant’s vital signs are: rectal temperature, 40°C; heart rate, 175 beats/min; blood pressure, 81/54 mm Hg; respiratory rate, 45 breaths/min; and oxygen saturation, 91% on room air. The physical examination is significant for rhinorrhea, lesions on the buccal mucosa, and bilateral conjunctival injection without purulent drainage. You note cervical lymphadenopathy and a blanching maculopapular exanthem on his face, trunk, extremities, palms, and soles. Upon auscultation, he has rales at both lung bases.
- You consider: What is the etiology for this patient’s fever and rash? What are the possible complications of his illness? Does this patient need diagnostic testing or specialty consultation? Should this patient be isolated in the ED, and should contacts be isolated or treated? What treatments are indicated? Should this patient be admitted?
Case Conclusion
Make your best guess and check back next month for the case conclusion!
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