What Will Be Your Differential Diagnoses For This Patient? Essay

920 Words Oct 29th, 2016 4 Pages
An eighteen-month-old child, well known to your practice, presents with a seven-day history of fever ranging from 101 to 104.7 degrees Fahrenheit. On the fourth day of the fever, the emergency department had performed the following tests:
• A blood and urine culture
• A complete blood count
• A comprehensive metabolic panel
The culture reports were found to be negative.
Today, the vitals of the child are the following:
• Temperature: 101.5 degrees Fahrenheit
• Heart rate: 120 beats/minute
• Respiratory rate: 20 breaths/minute
• Blood pressure: 90/40
Physical examination of the child indicates the following positive findings:
• Injected conjunctiva
• Palmar redness
• Magenta-colored lips
• Red macula
• Excoriating rashes in the diaper area
On the basis of the above information, respond to the following:
• What will be your differential diagnoses for this patient?
My differential diagnoses for this child would be:
1. Kawasaki disease.
2. Infectious diseases such as rubeola, streptococcal scarlet fever, Lyme disease, Rocky mountain spotted fever, infectious mononucleosis.
3. Drug reactions; Stevens-Johnson syndrome
4. Juvenile rheumatoid arthritis.

• What specific physical exam findings support these differential diagnoses?
I will quickly assess this child’s overall appearance for distress; signs of dehydration by checking for the capillary refill, poor skin turgor, and dry mucous membrane. Measure the vitals signs - carefully determine the temperature. Then, inspect the…

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