Term
| Three week old full term male born via vag delivery with a 1d hx of poor feeding. Temp 101.2. Lethargic, pale, fontanel seems full. Cried when moved gently. WBC 21k, with 70% neutrophils and 20% bands. CSF WBC 140 with 85% neutrophils |
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| Six month old female health until 3d ago. Developed fever jof 103-104 w/o other sympts. Her parents thought she was teething. She developed vomitting which is why they are here. On exam, she's alert nontoxic appearing w/o focus of fever. WBC 16k with 80% neutrophils. |
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| 18 mos old male presents in July with a 2d h/o of difficulty swallowing, refusing to eat or drink. Mother noted "bug bites" on his feet and hands. Mild fever of 100.8-101. on exam he has vesicles on his hands and feet. |
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Definition
| Cocksackie (Enteroviral) Hand-Foot-Mouth |
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| Seven year old girl in Sept presents with 3 d h/o fever 101-102, sore throat, tummy ache, and a faint rash on her trunk and privates. She had one episode of vomiting. One exam her throuat was beefy red with 2+ anterior nodes. There was an erythematous sandpaper rash over her trunk and genitals. |
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Definition
| Scarlet Fever from Grp A Beta-heme Strep |
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Term
| 16yo quartback of the HS football team. Presents with 7d h/o fatigue, sore throat and abd pain. One exam, markedly swollen tonsils with thick exudates. Ant and Post cervical nodes with a "bull neck". Abd is soft with spleen tip palpable 3cm below LCM. WBC 17k with 22% atypical lymphocytes |
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| 20mos unvaccinated girl presents with a 10d h/o of rhinorrhea, cough, an dlo fever. The AM had a sudden onset of right eyelid swelling and erythema and purulent discharge. On exam, an uncomfortable girl with marked swelling and erythema over right eyelid with a violaceous hue. Extraocular appear impaired in lateral gaze |
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Definition
| Orbital Cellulitis from H influenza type B (HiB) |
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| 15mos old female with a 3d h/o of fever 102-103 and irritability. She has no other sympts. Her fever has been gone for 24 hours, but she developed an erythmatous pinpoint rash on her face and trunck. |
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Definition
| Roseola (exanthema subitum) from HHV-6 |
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| 9yo boy in good health who was noticed to have "pink cheeks" over the weekend. His parents thought is was a sunburn. Now he has a lacy rash on his arms, legs abd upper chest. It gets worse in the sun. |
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Definition
| Fifth Dz (erythema infectiosum) |
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| 18yo female, college freshman, with 2d h/o of cold sympts. Suddenly develops a fever of 104, HA, vomitting and neck pain. She was brought to her univ health center where on exam a petechial rash was noticed on her distal extremities. |
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Definition
| N Meningitides meningitis |
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| 3yo boy adopted from Russia 1 wk ago, presents with an extremely pruritic rash over with extremities and trunk. More prominent on his hands, feet, and groin areas. His adopted parents were told it was "bug bites" from the orphanage. On exam, he has multiple papules and vesicles over his hands feet, axillae, and groin areas. |
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