A young girl with fever and atypical rash

Hoornaert, Ellen [UCL] Yombi, Jean Cyr [UCL] Yildiz, Halil [UCL]

A 17-year-old girl presented with a painful submandibular lymph node for 7 days, fever (up to 40°C) and asthenia for 5 days. She had no medical history and was not taking any medication. Vital signs were blood pressure 95/68 mm Hg, pulse 118 bpm, oxygen saturation 96% on room air. Physical examination showed a submandibular lymph node, bilateral conjunctivitis, palmoplantar erythrosis (figures 1 and 2) as well as a strawberry tongue (figure 3). Labs showed C-reactive protein at 338.7 mg/dL and white cell count at 11 720/µL (90% neutrophils). ECG demonstrated sinus tachycardia. Chest X-ray was normal and SARS-CoV-2 nasopharyngeal swab PCR was negative. [...]