Paediatric- History taking & Physical examination of a patient with fever and rash

Paediatric- History taking & Physical examination of a patient with fever and rashCreated OnApril 23, 2020Last Updated OnApril 23, 2020byadmin You are here: Main Clinical Examination Paediatric- History taking & Physical examination of a patient with fever and rash < All Topics Table of Contents History taking: Ask about patient’s data: name, age, gender Ask about history of presenting illness When did the rash start? Where did the rash start? Rubeola: rash begin on face, neck and shoulders Rubella: develop on forehead Erythema infectiosum: face (slapped cheek) Erythema multiforme: elbow, palm, knee, sole Meningococcemia: petechial lesions on trunk and extremities Scarlet fever: begin in trunk Kawasaki disease: rash on trunk and perineum Chickenpox: begin on face Lyme disease: upper limbs, chest and body creases Characteristic of rash Distribution and progression Rubeola, rubella, chickenpox: spreads inferiorly and to extremities Erythema infectiosum: progress into lacy reticular rash Erythema multiforme: from macule to papule, vesicles/ bulla may develop Scarlet fever: spread to extremities, sparing palms and soles Timing onset in relation to fever Very Sick Patients Must Take Double Tablets Varicella –              D1 of fever Scarlet fever –       D2 of fever SmallPox –            D3 of fever Measles –               D4 of fever Typhus –                D5 of fever Dengue –               D6 of fever Typhoid –              D7 of fever Morphological changes of lesion Erythema infectiosum: from “slapped cheek” rash to lacy reticular rash Assoc with desquamation: scarlet fever, toxic shock syndrome, Kawasaki disease Prodrome of URTI – measle, rubella, erythema infectiosum, chickenpox, roseola History of myalgia, arthralgia, headache – Lyme disease, dengue fever History of retroorbital pain, bleeding tendencies, abdominal pain/ distention, reduced urine output – dengue fever History of joint pain/ swelling, limping gait, rashes – systemic JIA History of malar flush, photosensitivity, oral ulcer, joint pain/ swelling – SLE History of red watery eyes, injected pharynx, red lips, strawberry tongue, swelling of palms and soles, rashes, lymphadenopathy – Kawasaki disease History of nausea, vomiting, neck stiffness, altered behaviour, fitting, petechial rash – meningococcemia Exposure to insects/ animals History of sick contact Recent travel? Ask about antenatal history Congenital infections? Ask about birth history Gestational age at delivery? Birth weight? Mode of delivery? History of postnatal complications? Ask about vaccination history Completely/ incompletely/ unimmunized? Ask about feeding history Type of food/ milk Frequency and amount being fed Any reduced oral intake/ loss of appetite Ask about developmental history Ask about past medical history Any underlying chronic illness causing immunosuppression Ask about drug history Recent use of medication – what drug?...

Continue reading

Please Login/Register to read full article.