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What specific physical exam findings support these differential diagnoses?

  • Assessment, diagnostic testing, and management of infectious conditions in a pediatric patient
  • Differential diagnoses for presentation of symptoms involving infectious diseases in pediatric patients
  • After completing your research, consider this scenario: An eighteen-month-old child, well-known to your practice, presents with a seven-day history of fever ranging from 101 to 104.7 degrees Fahrenheit. On the fourth day of the fever, the emergency department had performed the following tests:
    • A blood and urine culture
    • A complete blood count
    • A comprehensive metabolic panel
    The culture reports were found to be negative. Today, the vitals of the child are the following:
    • Temperature: 101.5 degrees Fahrenheit
    • Heart rate: 120 beats/minute
    • Respiratory rate: 20 breaths/minute
    • Blood pressure: 90/40
    Physical examination of the child indicates the following positive findings:
    • Injected conjunctiva
    • Palmar redness
    • Magenta-colored lips
    • Red macula
    • Excoriating rashes in the diaper area
    On the basis of the above information, respond to the following:
    • What will be your differential diagnoses for this patient?
    • What specific physical exam findings support these differential diagnoses?
    • Of the differential diagnoses you listed, which would be the most concerning?
    • What additional diagnostic tests will you recommend? Why?
    • What would be your focus for caregiver education?
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