1. Exanthema Subitum (Roseola). Olive’s symptoms of cough, runny nose, and a fever of 103 that
resolved 2 days ago followed by the appearance of a rash that began on her abdomen and spread to her
arms and legs make thi
...
1. Exanthema Subitum (Roseola). Olive’s symptoms of cough, runny nose, and a fever of 103 that
resolved 2 days ago followed by the appearance of a rash that began on her abdomen and spread to her
arms and legs make this the leading diagnosis (Kaneshiro & Zieve, 2019; Trembly & Brady, 2019). The
physical exam findings of a maculopapular pink rash to the abdomen and extremities further support
this diagnosis (Kaneshiro & Zieve, 2019; Trembly & Brady, 2019).
2. Human Parvovirus 19 (Fifth Disease, Erythema Infectiosum). Olive’s symptoms of cough, runny
nose, and fever accompanied by a rash make this diagnosis a consideration (Centers for Disease Control
and Prevention, 2019). However, the rash in Fifth Disease is present on the face and has a characteristic
“slapped cheek” appearance and may spread to the chest, back, buttocks, and extremities (Centers for
Disease Control and Prevention, 2019). The physical exam findings of a maculopapular pink rash to the
abdomen and extremities and absence of the classical slapped cheek appearance coupled with reports
of the rash beginning on the abdomen, rule this diagnosis out.
3. Measles. Olive’s symptoms of cough, fever, runny nose, and rash make this diagnosis a
consideration (Centers for Disease Control and Prevention, 2020a). However, the lack of physical
examination findings of red and watery eyes, Koplik spots, and the pattern of Olive’s rash (spreading
from abdomen to arms and legs versus from the head downward) rule this diagnosis out (Centers for
Disease Control and Prevention, 2020a). Lastly, Olive is up-to-date on her immunizations making this
diagnosis less likely.
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