Frank, an 8-year-old male, presents to your clinic this afternoon with a 2 day history of fever, sore throat, and headache.
Frank, an 8-year-old male, presents to your clinic this afternoon with a 2 day history of fever, sore throat, and headache. His mother also states that he has occasionally been complaining that his belly hurts. Mom has been giving him Tylenol every 4 – 6 hours. His appetite is poor, but he has been drinking juice and water pretty well. This morning the boy’s mother noticed that he developed a red, bumpy rash on his neck and under his arms. PMH is unremarkable. His immunizations are UTD. PE: T=38.9 C, HR= 88, RR= 20, weight = 37 kg He is nontoxic but uncomfortable appearing. His tonsils are erythematous and 3+ with white exudate. He his several petechiae on his soft palate. He has a few tender anterior cervical lymph nodes and an erythematous popular rash most prominent on the neck and in his axilla. His cardiopulmonary exam is normal, and his abdomen is nontender and otherwise benign. 1. List 3-4 differential diagnosis for Frank. 2. List pertinent positives and negatives from the exam. 3. What laboratory tests will you obtain initially? 4. While waiting for the test, you explain to Frank’s parent that the organism most likely causing the rash
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