Project Description

Unsettled Toddler

History of Present Illness:

19-month old patient presenting with unexplained, intermittent consolable crying and subfebrile temperatures (max 38.0°) since the previous day, as well as a single episode of non-bilious vomiting after breakfast. No further abnormalities in the review of symptoms.

Past Medical History:

Viral pharyngitis 10 days prior, symptom free interval of 1 week. Atypical Kawasaki 6 months prior. Vaccinations according to guidelines.

Physical Examination:

Patient in fair general condition, afebrile, vitals stable, mild pharyngitis, further examination without pathological findings.

Progress:

We decided on symptomatic treatment and follow-up the following day.

The Patient returns the same evening due to progressing symptoms (persistent crying) and febrile temperatures.

Physical Examination 2:

Decreased general condition wihle febrile with tachycardia and tachypnea (normal vitals after antipyretics), mild pharyngitis and possible abdominal tenderness. Further examination without pathological findings, notably no nuchal rigidity.

Quiz

What would you do next?
What would you do next?