Case history
Case history #1
A 5-year-old girl presents 1 day following the onset of fever and a diffuse, red, fine, "bumpy" rash that started around her neck and upper trunk and subsequently spread to her extremities. She does not have any rhinorrhea, cough, conjunctivitis, or gastrointestinal symptoms, but reports a sore throat. On examination, she has a temperature of 101.3°F (38.5°C); erythematous, swollen tonsils; and a diffuse, erythematous, finely papular rash on her neck, trunk, arms, and legs that spares the palms and soles.
Case history #2
A 14-year-old boy presents 2 days following the onset of progressive redness, tenderness, and purulent drainage from a wound on his right thigh. A diffuse rash appeared on his legs and trunk the previous day. The patient initially sustained an abrasion on his right thigh after falling from his skateboard 5 days prior to presentation. He continued to skateboard for several hours and did not perform basic first aid or cleansing of the wound. On examination, he has an elevated temperature of 100.9°F (38.3°C); a 3 cm erythematous, tender, fluctuant area of his thigh, with a central bulla that is spontaneously draining scant amounts of purulent fluid; and a diffuse, erythematous, "sandpaper-like" textured rash on his bilateral lower extremities and trunk.
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