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Courtesy of the CDC

Case Study 2
A five-year-old female who lived in Missouri was taken to the emergency department (ED) in June. She had a three day history of intermittent headache, nausea, and a sore throat. Her temperature was 105o F (40.6o C) and she had a maculopapular rash on her legs and the soles of her feet. Laboratory tests were performed. Results of laboratory studies include:
  • 8.8 X 109/mL WBC
  • 5% band forms
  • 70% neutrophils
  • No morulae or spirochetes observed
  • 50 x 109/mL platelets
  • Mild elevation in liver transaminases
  • Hyponatremia
Which of the following should be considered in the differential diagnosis of a child with high fever and a rash?

Please select the single best answer