Visual diagnoses

I like a good visual diagnosis. I've had a couple in the minor emergency clinic over the last few days:

1) Fifth disease (parvovirus) - macular to lacy rash starting on the face (slapped cheek rash) and the moving to the trunk and extremities, especially extensor surfaces.


2) Coxsackie virus (hand foot and mouth disease):
Child presented with high fever (40 degrees celcius) and no other symptoms. Resp virus going around at daycare. Throat looked like this:
but my patient had more vesicles present all over both tonsils and the uvula. Coxsackie virus is classic for this. Can also cause blistering lesions around the lips, inside the gums, inside the cheeks. In the classic cases there is a blistering rash on the hands and feet, but not always present.

3) Add in a good subconjunctival hemorrhage today with a small abraison on the conjunctiva showing up with fluorescein dye and it was a pretty good day.

I'm on call tomorrow for the NICU - not looking forward to it. It's hard when you haven't done any time in NICU and you have to go and round on all of the patients! Argh!