Index of suspicion. Case 1: fever, barking cough, stridor, and rash in an infant. Case 2: erythematous papulovesicular rash in a 3-month-old girl. Case 3: vomiting and unrelenting headaches in a 5-year-old girl.

摘要

A 6-month-old boy presents with a temperature of 38.9degC and barking cough of 3 days' duration as well as a rash over his body for 1 day. On physical examination, his temperature is 37.5degC, respiratory rate is 28 breaths/min, and blood pressure is 87/52 mmHg. He appears nontoxic and has a barking cough, injected conjunctiva with whitish discharge, dry lips, mild inspiratory stridor, a blanching erythematous maculopap-ular rash on his trunk and extremities, and small cervical lymph nodes. The rest of his physical findings are normal.His Hgb is 12.8 g/dL (128 g/L), WBCcountisll.7xl0~3/mcL(11.7X 10~9/L) with 75% neutrophils and 23% lymphocytes, and platelet count is 515xl0~3/rncL(515xl0~9/L).