A mother had come to the ED with her 10 y/o daughter. The mother had explained that her daughter was seen earlier in our ED and referred to ENT clinic for a swollen mass in the neck. She had however brought to the her panel family med clinic which had referred her again to us for a CBC test.
The girl had noted with a temperature of 37.6°C at the triage station.
The mass was apparently a lymph node located just below the mandible angle. I did a quick PE and found that there was no obvious lesion in the head region. Just as I wanted to proceed to the examination of the trunk, the mother had told me that there was this blister noted around the girl's left shoulder. I adjusted the girl's shirt and found some blisters at both of her shoulder and further examination had revealed blisters over the neck base as well.
The answer was straight forward at that time - chicken pox.I reassured the mother and sent the patient's home......
Wild goose chase which ended up with a spot diagnosis.
back to the basic-> careful history and PE conclude most of the case.
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