Diagnostic Dilemma

Fever, rash and convulsions


Author: Pediatric Oncall
Question
A 2½ years old boy born of third degree consanguineous marriage presented with fever since 6 days and maculopapular rash since 2 days. He had a generalized tonic clonic convulsion 2 hours back with post ictal drowsiness. There is no otorrhoea, vomiting or focal neurological deficit. On examination, he was febrile, had tachycardia (120/min) with B.P. of 90/60 mm of Hg and was drowsy. There were no cranial or focal neurological deficit and deep tendon reflexes were brisk with extensor planters. He had erythematous maculopapular rash over face and extremities and a soft hepatomegaly. There were no meningeal signs. Tache Cerebrale sign was negative. The child was treated with antibiotics and acyclovir.

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