A healthy, immunized 8-year-old girl presents to the pediatric emergency department (PED) with 10 days of fever, 4 days of abdominal pain, 3 days of nonbloody diarrhea (3–4 episodes daily), 2 episodes of nonbloody and nonbilious emesis, and a new transient urticarial rash. She returned from India 5 weeks before presentation and developed sore throat and fever 4 weeks before presentation. At that time, she was diagnosed as having streptococcal pharyngitis and was prescribed amoxicillin. After 3 days of taking amoxicillin, she became afebrile, she then completed the 10-day course and remained afebrile for another 5 days off amoxicillin. However, 10 days before presentation, she became febrile again. She tested positive for streptococcal pharyngitis again 2 days later and was prescribed cefdinir for presumed treatment failure. She continued to have fever, and the day before presentation, 8 days on cefdinir, she developed an urticarial rash, with conjunctival injection. Given concerns...
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Index of Suspicion| May 01 2022
Prolonged Fever, Travel, and the Changing Examination in an 8-year-old Girl
Zobiya Momin, MD;
Shelease O’Bryant, MD;
Pediatr Rev (2022) 43 (5): 280–284.
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Zobiya Momin, Shelease O’Bryant, Sarah Meskill; Prolonged Fever, Travel, and the Changing Examination in an 8-year-old Girl. Pediatr Rev May 2022; 43 (5): 280–284. https://doi.org/10.1542/pir.2020-004044
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