After completing your research, consider this scenario:
An eighteen-month-old child, well-known to your practice, presents with a seven-day history of fever ranging from 101 to 104.7 degrees Fahrenheit. On the fourth day of the fever, the emergency department had performed the following tests:
A blood and urine culture
A complete blood count
A comprehensive metabolic panel
The culture reports were found to be negative.
Today, the vitals of the child are the following:
Temperature: 101.5 degrees Fahrenheit
Heart rate: 120 beats/minute
Respiratory rate: 20 breaths/minute
Blood pressure: 90/40
Physical examination of the child indicates the following positive findings:
Excoriating rashes in the diaper area
On the basis of the above information, respond to the following:
What will be your differential diagnoses for this patient?
What specific physical exam findings support these differential diagnoses?
Of the differential diagnoses you listed, which would be the most concerning?
What additional diagnostic tests will you recommend? Why?
What would be your focus for caregiver education?