Infectious Disease for Medical Students and Residents
A 16 year old male high school student is referred to your clinic for a peculiar rash on his right forehead. The patient is concerned not only for the unsightly appearance of the rash, but also as it is quite painful when he combs his hair or wears a cap. The rash consist of numerous small vesicles on an erythematous base, and continues past his hairline.
During physical exam, you note that several of the vesicles have coalesced, while others appear to have developed a yellow, crusted appearance. There are no other lesions found on his body. Based on the appearance of the rash and the symptoms, your presumptive diagnosis is:
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A three-year-old female was brought to Emergency in December because of vomiting and diarrhea. Her mother reports that she has been drinking more water than usual but is unable to keep liquids down. Her temperature is 39.5, she is slightly tachycardic (105 beats/min) and respirations of 26/min. Urine had a high specific gravity and was negative for fecal leukocytes
What is the first thing you should initiate for this child?
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Exquisitly painful small vesicles clustered together on an erythematous base is a classic description of herpes simplex. While herpes simplex is typically thought of as "cold sores" or "fever blisters" occuring on the oral mucosa or genitals, herpes simplex may infect through any break in the skin. Herpes gladiatorum is the diagnosis of herpes simplex infection of skin, often trasmitted during sports with close contact (such as wrestling).