The clinic nurse assesses an 8-year-old client who reports a sore throat and has a bright red, pruritic rash on the chest that feels like fine bumps and looks like a sunburn. Which diagnostic tool does the nurse anticipate the health care provider will prescribe?

Question

The clinic nurse assesses an 8-year-old client who reports a sore throat and has a bright red, pruritic rash on the chest that feels like fine bumps and looks like a sunburn.  Which diagnostic tool does the nurse anticipate the health care provider will prescribe?

Quizplus · Accepted Answer

11ecbb05_cade_c43e_b433_75ee3c50667b_MD0009_00 Scarlet fever (ie, scarlatina), a complication of group A streptococcal infection (eg, streptococcal pharyngitis), is common in early childhood and is characterized by a distinctive red rash. The rash begins on the neck and chest and spreads to the extremities, resembles a bad sunburn, blanches with pressure, and has fine bumps like sandpaper. Additional manifestations of streptococcal pharyngitis (eg, exudative pharyngitis, fever, swollen anterior cervical lymph nodes) are typically present. Because the clinical presentation (ie, rash plus sore throat) is characteristic, but not diagnostic, of scarlet fever, the health care provider will prescribe a rapid streptococcal antigen test to confirm symptom etiology (Option C). Swabbing the posterior pharynx and tonsils provides test results within minutes. Throat culture may be necessary to verify results. (Option A) Dermatologic manifestations of an allergic reaction (eg, contact dermatitis) may necessitate allergy testing (eg, scratch or patch testing). However, the client's symptoms are characteristic of scarlet fever, not an allergic reaction. (Option B) A complete blood count may reveal elevated WBCs in the presence of any infection, but this is not diagnostic for streptococcal pharyngitis. (Option D) A skin biopsy involves removing skin and examining it under a microscope to detect certain dermatologic conditions (eg, infection, lupus) but is not anticipated because the client's symptoms are characteristic of scarlet fever. Educational objective: Scarlet fever (ie, scarlatina), a complication of group A streptococcal infection (eg, streptococcal pharyngitis), is characterized by a distinctive red rash. Diagnosis is based on clinical presentation, rapid streptococcal antigen testing, and possible throat culture.

The Clinic Nurse Assesses an 8-Year-Old Client Who Reports a Sore