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Based on the symptoms,
Differential diagnoses for the boy includes:
- Rocky Mountain Spotted Fever (RMSF) owing to his recent visit to Florida
- Meningitis
Course of treatment:
- The patient needs to be admitted
- Diagnostic tests including CBC, cultures of both blood and CSF to rule out meningitis should be done
Explanation:
Initial line of treatment with loading dose of doxycycline at 2.2 mg/kg and ceftriaxone at 100 mg/kg/day can be started.
RMSF is a contagious disease caused by ticks and is predominant in the southeastern regions of the United States like North Carolina. So the boy could have got the disease from his visit to N. Carolina. Doxycycline is a broad spectrum antibiotic is the most preferred treatment of choice for RMSF
Meningitis is a bacterial disease affecting the brain. Ceftriaxone is the treatment of choice for empirical treatment of meningitis.
Since the boy’s symptoms like fever, headache, petechial rashes etc are symptomatic of both RMSF and meningitis, both the antibiotics should be administered initially.
Then depending upon the culture results, other specific antibiotics and treatments can be started.
Answer:
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