Case Study 2, continued
To narrow the diagnosis, more information is required. Healthcare personnel should determine the following points:
- How long has the rash been there? She developed the rash on the day of admission to the ED.
- Where did the rash appear before the onset of fever? Her rash appeared on the arms and legs and then spread to her palms and the soles of her feet.
- Was she taking any medications? No, she had only taken acetaminophen for fever.
- Did she have any immunocompromising conditions? No
- What recent activities did she perform, and did she travel anywhere? She had only played in the neighborhood and had not left the local area in the last month.
- Were any of her contacts ill? None were identified.
- What pets was she exposed to? The family did not have a dog or cat.
- Was there a history of a tick bite? No, but ticks were found in the yard where she played.
- Was a direct antigen test for Streptococcus pyogenes performed? Yes, it was negative.
With this additional information, what do you now suspect the diagnosis to be?
Please select the single best answer