Hand foot and mouth disease suspected in child

Age: ‍ years old

Gender: ‍malefemale



HISTORY:

Presents with a ‍-‍day history of ‍rashfeversore throat

Location is on ‍face, ‍neck, ‍arm, ‍hand, ‍leg, ‍foot, ‍thorax, ‍abdomen, ‍flank, ‍back, ‍painfulnot painful

Alleviating factors: ‍none, ‍effectiveineffective



Associated symptoms: *Try using right-click for negatives*

‍fever, up to ‍°, over ‍ ‍hoursdays

‍chills

‍sore throat

‍painful sores in the mouth

‍fatigue

‍lethargy

‍irritability

‍decrease in fluid intake

‍decrease in urine ouput

‍decrease in appetite

‍cough, ‍non-productiveproductive of ‍clearcolored phlegm

‍runny nose, ‍clearcolored

‍shortness of breath

‍chest pain, ‍retrosternal, ‍aching, ‍on exertionat restwith deep breath, ‍mild

‍headache, ‍diffuse, ‍persistentintermittent, ‍pressurethrobbing, ‍mild

‍joint pain

‍nausea

‍vomiting, ‍ episodes ‍per day, ‍, ‍hematemesis

‍diarrhea, ‍ episodes ‍per day, ‍

‍abdominal pain, ‍diffuse, ‍dull, ‍mild

‍dysuria

‍frequency

‍foul-smelling urine



Contributing factors:

‍daycare

‍similar symptoms in close contacts

‍recent travel

‍recent upper respiratory infection

no history of: ‍asthma, ‍premature birth



Vaccination status: ‍up-to-dateincompleteunvaccinated





EXAM:

General appearance: ‍well-appearing, ‍apparent distress

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Head: ‍normocephalicatraumatic, scalp ‍normalrashlesion

Eyes: conjunctiva/sclera ‍normal, lids/lashes ‍normal

Ears: tympanic membranes ‍normal ‍, auditory canal ‍ on ‍rightleft, hearing ‍intact

Nose: ‍clear, discharge ‍clear, ‍

Throat: ‍normal, ‍erythema, ‍exudate, ‍

Neck: ‍normal, ‍lymphadenopathy, ‍, c-spine ‍

Heart: ‍RRR, ‍MRG, ‍normal S1 and S2

Lungs: ‍clear bilaterally, ‍abnormal sounds, ‍retractions

Abdomen: ‍soft, ‍non-tender ‍, ‍non-distended, ‍guarding, bowel sounds ‍normal, ‍, ‍CVA tenderness ‍

Skin: ‍rashlesions on ‍

Extremities: ‍warm, ‍dry, cap refill ‍< 3> 3 sec, pulses ‍intact, ‍edema ‍bilaterally, ‍

Musculoskeletal: joints ‍ ‍normal, ‍limited ROM





ASSESSMENT:

‍Hand foot and mouth disease ‍likelysuspectedpossible

DDx: hand foot and mouth disease, herpangina, Strep pharyngitis, varicella, HSV infection, impetigo, scabies, fungal infection, erythema multiforme, Kawasaki disease, drug reaction, stevens-johnson syndrome, measles, rubella, scarlet fever, contact dermatitis, atopic dermatitis, urticaria





PLAN:

Investigations:

- Throat swab

Treatments:

- ‍Acetaminophen (Pediatric)

- ‍Ibuprofen (Pediatric)

- Encourage hydration

- Soft diet

- Avoidance of acidic or spicy foods

Further care:

- Follow-up in ‍ ‍daysweeks