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Case Study 2, continued
In order 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 acetominaphen 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