A 2 year old child with rash and fever

doi:10.1136/bmj.327.7417.720

BMJ 2003;327:720 (27 September), doi:10.1136/bmj.327.7417.720

Clinical review

Interactive case report

A 2 year old child with rash and fever

Rita Sharma, clinical lecturer¹, Andrew Boon, consultant paediatrician², Anthony Harnden, university lecturer¹

¹ Department of Primary Health Care, Institute of Health Sciences, Oxford OX3 7LF, ² Royal Berkshire Hospital, Reading RG1 5AN

Correspondence to: A Harnden anthony.harnden@dphpc.ox.ac.uk

The first 150 words of the full text of this article appear below.

Last week (20 September, p 668) we described the case of a 2year old girl with a maculopapular rash, fever, and dehydration.Her general practitioner thought she had a self limiting viralillness but encouraged her father to return with Elisabeth ifher symptoms didn't resolve. To look at discussion of the caseso far go to bmj.com

Elisabeth returned to nursery. Over the next two weeks she spikedintermittent fevers of up to 39°C (fig 1). Her appetitecontinued to be poor and she was sleeping more. Although brightand alert at times, she was not her usual self and sometimesbecame clingy and irritable. Seventeen days after her initialfever, the skin over Elisabeth's fingers and toes peeled (fig 2).Her mother, concerned at this point, contacted an anaesthetistcolleague. Elisabeth was seen at her local hospital by a paediatrician.

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Fig 1 Elisabeth's temperature . . . [Full text of this article]

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