A Puzzling Facial Rash on a 17-Year-Old Boy

Faisal M. Mawri, MD; Nida Yousef, MD; Ammar Alhmood, MD; Walid Abuhammour, MD, FAAP, FIDSA


July 09, 2018

Physical Examination and Workup

Upon physical examination, the patient is alert and orientated. His oral temperature is 97°F (36.1°C). The patient has normal heart sounds, his pulse has a regular rhythm of 97 beats/min, and his blood pressure is 125/75 mm Hg. His lungs are clear, and his respiratory rate is 12 breaths/min. The examination of the head, eyes, ears, and nose is remarkable for multiple vesicular lesions measuring about 0.5 cm in diameter (see Figures 1 and 2).

Figure 1.

Figure 2.

Bilateral submandibular lymph gland enlargement measures 1.5 × 1 cm. The neck is supple. His abdomen is soft and nontender to deep palpation in the epigastric region, and no organomegaly is noted. A CBC taken at the PCP's office showed a white blood cell (WBC) count of 7.4 × 103/µL (7.4 × 109/L), with a normal differential; a hemoglobin level of 13.6 g/dL (136 g/L); a hematocrit level of 38.3% (0.3830); and a platelet count of 298 × 103/uL (298 × 109/L).


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