ER Trip #4

(Warning Garett wrote this post while studying, hence the medical write up.)

2yr 9 month old boy presents to the emergency room with irregular
raised and flat sores on his trunk and extremities along with
bilateral swollen, painful knees that are warm to the touch. These
symptoms started this morning but have progressed throughout the day.The boy will not bend his knees and refuses to walk due to the pain. A week prior he was treated for bilateral ear infection, red eyes,swollen lymph nodes and sores at the back of his mouth with
amoxicillin.What is the likely diagnosis?

A) Kawaski Disease (Fever, mouth sores, red eyes, polymorphous rash,
swollen lymph nodes, red swollen hands and feet - disease leads to
coronary aneurysm and fatality in up to 3% of cases )

B) Serum sickness / Immune complex disease (Fever, itching, joint pain
following exposure to allergen - disease is self limited with removal
of allergen)

C) Post Viral Arthralgia (Pain, swelling, and tenderness in joints
aggravated by movement. Follows infection)

Yes, it is Spencer, the man of the hour. As you can see his symptoms
presented us with quite the dilemma. Worst case he could have
something that could kill, best case it was an allergic reaction.
After consulting with some doctors and watching his symptoms get
progressively worse, we took him to the pediatric ER. They put him in
a room very quickly and much to our surprise diagnosed him with (B)
serum sickness. We weren't quite convinced at first, but we will go
with that for the time being. No more penicillins for him.