Authors: Ivana Lutchman / Editor: Thomas MacMahon / Reviewer: Sarah Gooding / Codes: DP1, IP1, SLO1, SLO5 / Published: 08/10/2022

A 4-year-old boy presents to the Emergency Department (ED) due to a 5 day history of general malaise, pyrexia, coughing and a rash. He’s also developed pains in his legs over the last 24 hours, causing him difficulty in standing.

The rash consists of 1-2cm circular raised erythematous spots in an uneven distribution mainly over his anterior chest and thighs, with a few on his abdomen, arms and face.

On examination he has mild cervical lymphadenopathy and erythematous tympanic membranes. He has no recent foreign travel and is up to date with his immunisations.