Reference no: EM133766039

Question

An 11-year-old girl presents to her pediatrics office with her father complaining of left knee pain with warmth and swelling as well as a rash on her chest and both arms and legs for the past 2 days. She denies any known injury and denies joint locking or instability. She admits to generalized achiness and fatigue over the past week and a fever of 102.5F last night but denies chills or night sweats. She was seen by another provider in the practice 6 days prior for a sore throat and low-grade fever. Her sister had been diagnosed with group A strep on a rapid strep test, so amoxicillin 250 mg PO TID was prescribed without lab testing. The rash is not pruritic but is intermittent, occurring more at night when she has a fever. She denies changes in diet, soaps, or detergents. She takes no medications other than the current amoxicillin; she has taken amoxicillin previously without rash or reaction. She is generally well. She is a ballet dancer and has been on a heavy rehearsal schedule preparing for a performance in 1 month. She is new to on-point toe dancing, beginning 8 months ago, and had some initial bilateral.