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Rash in Creases

UnFiNiShEd CaSe CoMe BaCk LaTeR

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History of Present Illness:

A 3-year-old male is brought to the ED for 1 day of poor fluid intake and 2 days of a painful rash around the mouth, axilla, collar, armpits, inner elbows and groin. They noticed some minor blistering with some areas turning to small scabs.  There has been a low grade fever up to 100.4

Vital Signs & Physical Exam:

Vital signs are normal.  Physical exam is normal except for the child is crying and there is a scattered rash mostly in creases/flexural areas with superficial sloughing.  The throat and peri-oral areas are erythematous with some small areas of sloughing.

Initial Differential Diagnosis: impetigo, scarlet fever, viral syndrome, scalded skin syndrome, candidal intertrigo

Initial Diagnostic Testing:

  • Labs: normal except for bicarb of 18 and lactic acid of 2.3
  • Imaging: none

QUESTIONS:

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  2. What should you do next?  
  3. Want a 1-minute consult/tutorial on this case? 
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ANSWERS:

  1. What does the case image show?  The image shows .
  2. What should you do next?  Treat with.  Consult.
  3. Want a 1-minute consult/tutorial on this case?  See yellow area from sample page below.
  4. Want to know what happened with this patient?  See case conclusion below tutorial page.

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CASE CONCLUSION: We’ll just have to see

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