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Author: Nauman Arshad / Editor: Fiona Mendes / Codes: CC12, DP2, GP1, GP9, IC4, IP1, SLO5Published: 01/05/2024

A 3-year-old girl presents to emergency department (ED) with a 5-day history of fever, runny nose and abdominal pain. She has had two episodes of vomiting over the last 2-days. Her mother noticed that she has red rash on her face, chest and upper back.

Vital signs:

  • Oxygen saturations in room air: 97%
  • Respiratory rate: 34 breaths per minute.
  • Cap refill < 2 seconds peripherally.
  • Pulse: 128 beats per minute.
  • Temperature: 38.6 degree Celsius.

On examination, of note:

Eyes: Bilateral eye redness (conjunctival injection) without any purulent discharge.

Mouth appears dry, fissured and with erythematous lips.

There is right-sided cervical lymphadenopathy.

The lungs are clear on auscultation. Abdomen is soft and non-tender on palpation.

She has a fine erythematous maculopapular rash on her face, chest and on upper part of her back.