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A 3-Year-Old Boy Is Brought to the Emergency Department for Evaluation

question 176

Multiple Choice

A 3-year-old boy is brought to the emergency department for evaluation of a rash. The rash started on his face yesterday and has since spread to his chest, back, and arms. He has also had a runny nose, dry cough, and fever for the past week. The patient is irritable and uninterested in playing. He has not received vaccinations since age 6 months and takes no medications. A few weeks ago, he went on a camping trip in North Carolina but has not traveled outside the country. Temperature is 40.6 C (105 F) , pulse is 130/min, and respirations are 24/min. Examination shows a tired-appearing boy with watery and injected bilateral conjunctivae. Tiny white round lesions are present on the buccal mucosa next to the first and second upper molars. The oropharynx and tonsils are erythematous. Small, soft, mobile lymph nodes are palpated along the anterior and posterior cervical chains. The nontender, blanching rash is shown below. Which of the following is the most likely diagnosis in this patient?

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Definitions:

Voracious Eaters

Individuals or animals with a very keen or insatiable appetite for food.

Motor Development

The progression of muscular coordination and the ability of individuals to move and control their bodies.

Cephalocaudal

From head to tail.

Proximodistal

From the inner part (or axis) of the body outward.