A 2-Year-Old-Boy With an Alarming Facial Rash

Buraa Kubaisi, MD; Nakhoul Nakhoul, MD; C. Stephen Foster, MD

Disclosures

January 22, 2019

Editor's Note:
The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.

Background

A 2-year-old boy presented to the emergency department (ED) with fever and malaise that started 4 days earlier. His mother treated him with children's ibuprofen (100 mg). Six hours later, the fever and malaise persisted; his mother gave him additional ibuprofen.

The next day, the child awakened with a rash, initially on his face and upper part of his body. His mother took him to the ED of a local hospital. The child was diagnosed with chickenpox, and the mother was instructed to keep him at rest and treat with hydration and ibuprofen as needed for fever.

His mother observed worsening symptoms within 24 hours and brought him back to the ED.

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