This rash occurred in an 8 year old child who was traveling around the United States with his family. He presented with fever, headache, malaise, myalgias, and arthralgias. He also complained of abdominal pain, but ultrasound ruled out appendicitis. This rash developed about three days after the onset of the other symptoms. The rash is blanchable and began at the wrists and ankles. You also note some pedal edema. There is no meningismus. The CBC shows a normal white blood cell count, but thrombocytopenia. Sodium is on the low side. Blood cultures are negative.
Challenge: Time's running out...What's your diagnosis?
rocky mountain spotted fever!
ReplyDeleterickettsioses (rocky mountain fever)
ReplyDeletestart the kid on Doxycyclin
you're both right! i haven't actually seen this in real life, but it's always on tests
ReplyDelete-
Tick Tock
This is rocky mountain spotted fever, a tick-borne disease caused by Rickettsia rickettsii.
Source: UpToDate.