Author: Joel Chilaka / Editor: Sarah Edwards / Codes: DC5, SLO5 / Published: 29/05/2025
Patient 1: 8-year-old girl
An 8-year-old girl presents to the Emergency Department (ED) with a limp and an inability to bear weight for two days.
Her history suggests she may have fallen in her hot tub, raising concerns about a traumatic injury. The ED team evaluates her and performs an X-ray to rule out a fracture. She returns the following day after radiology questions a possible missed fracture.
On examination, she has a warm, tender maculopapular rash on both feet, with lumpy nodules more prominent on the balls of her toes and the base of her metatarsals. Despite the limp, she appears systemically well, with no bony tenderness or clinical signs of a fracture.
Patient 2: 14-year-old girl
Later that evening, a 14-year-old girl presents with a high fever and a similar rash on her feet and her torso. She has no history of trauma but reports malaise and generalized discomfort. Further questioning reveals that she has been at a friend’s swimming birthday party and has also been in her hot tub.
