Innocuous
Skin & Subcutaneous Tissue
0
{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/P13_F1.jpg"}},{"insert":"\n\n"},{"insert":"Lunchtime over, you head back to the pediatric clinic. \u00a0\r\n\r\n\u0022Shall I send the next patient in?\u0022, your nurse asks.\r\n\r\nYou respond in the affirmative and are introduced to six-year-old Simon, who is accompanied by his mother, Fiona.\n"}]}
1
{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/P13_F2.jpg"}},{"insert":"\n\n"},{"insert":"Fiona says that Simon has had several \u0022eruptions\u0022 on his face for the last three days.\r\n\r\nHe was completely well earlier, with unremarkable medical and surgical histories. All immunizations are up to date, and his growth and development are age-appropriate.\n"}]}
2
{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/P13_F3.jpg"}},{"insert":"\n\n"},{"insert":"Simon\u0027s vital signs are as follows: pulse 100 bpm, respiratory rate 24 cpm, blood pressure 100\/60 mmHg, oral temperature 97.7\u00b0F (36.5\u00b0C).\n\nDuring the general examination, you notice two vesiculopustular lesions with an erythematous base on the right labial commissure. Both are around 1.5 cm in size. You also notice a honey-colored crust with a moist erythematous base over the right nostril. This is 2.0 cm in size.\r\n\r\nSeveral small lymph nodes are palpable in the right submandibular region. They are mobile and non-tender.\n"}]}
3
{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/P13_F2.jpg"}},{"insert":"\n\n"},{"insert":"The remainder of the physical examination is unremarkable.\r\n\r\nYou sit back and ponder what to do next.\n"}]}
4
{"ops":[{"insert":"What will you do now?\n"}]}
1. Obtain a skin swab from underneath the crust
2. Obtain swabs of the nares and throat
3. Order no investigations for now
6
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7
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5
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