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A 4-year-old boy is brought in by his mother. He was mildly unwell yesterday with a fever, lethargy, and sore throat. Today, his mother is alarmed as she has noticed 'blisters' in and around his mouth, and he is reluctant to eat or drink.

On examination, the child looks miserable but not severely unwell. His temperature is 38.2ºC, and he has a mix of shallow ulcers and erythematous papules scattered over his hard palate, tongue, and lips. Upon further examination, you also notice a few erythematous maculopapular lesions along the sides of his fingers, around his right heel, and over his buttocks.

What is the most likely diagnosis?

A. Chicken pox
B. Measles
C. Shingles
D. Hand, foot, and mouth disease
E. Pompholyx eczema

Answer :

Final answer:

The 4-year-old boy's symptoms suggest he is likely suffering from hand, foot, and mouth disease, characterized by a fever, sore throat, and subsequent development of painful sores in the mouth and a rash with blisters on hands, feet, and sometimes buttocks and legs.

Explanation:

The symptoms that are presented by the 4-year-old boy suggest that he is likely suffering from hand, foot, and mouth disease. This illness is often characterized by a fever, sore throat, and a feeling of being unwell, followed by the development of painful sores in the mouth and a non-itchy skin rash, often with blisters, on hands, feet, and sometimes buttocks and legs. As indicated in this case, the rash may take the form of erythematous papules and maculopapular lesions, primarily on the hands and feet, and also potentially on the buttocks, as noted in this child.

This disease is a common infectious disease caused by several types of enteroviruses. It frequently occurs in children under the age of 5, which fits the age of this child. It is worth mentioning that the other illnesses can be ruled out based on the presented symptoms: chicken pox and shingles typically show a more widespread rash rather than being focused on hands, feet, and mouth; measles presents with a macular rash that starts on the face and spread to other parts of the body, which doesn't match the child's presentation, and Pompholyx eczema is usually intensely itchy - another symptom that has not been reported by this child's mother.

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Final answer:

The 4-year-old boy's symptoms align with Hand, foot, and mouth disease. This is a common viral illness characterized by mouth blisters and rashes on the hands and feet, usually among children.

Explanation:

Given the symptoms presented, such as mouth blisters, reluctance to eat or drink, and erythematous maculopapular lesions on various body parts, the most likely diagnosis for the 4-year-old boy is Hand, foot, and mouth disease. This is a common viral illness that typically affects children. It's characterized by lesions in the mouth and on the hands and feet, which aligns with the presented symptoms. The disease typically starts with a mild fever, sore throat, and lethargy - symptoms that the boy in question displayed a day before the mother noticed the blisters. Hand, foot, and mouth disease is usually self-limiting, which means it goes away on its own without treatment. Any care given is aimed at relieving symptoms until the virus runs its course, similar to the common cold.

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