Case Challenge| Volume 19, ISSUE 3, 104509, March 2023

16-Year-Old Male With 1-Month History of Pruritic Rash and 10 Days of Fever

Published:February 02, 2023DOI:


      • The differential diagnosis for fever of unknown origin is broad.
      • Subtle clues on examination and in the patient history can help to narrow down the differential without extensive workup.


      Patients presenting with complaints of prolonged fever may be difficult to evaluate. The differential diagnoses for a pediatric patient with prolonged fever and rash can be broad. This case highlights the case of a 16-year-old adolescent who presented to the emergency department with these symptoms. This article reviews important items in the history and physical examination to consider when narrowing this list of differentials. Diagnostic evaluation, management, and patient and family teaching are reviewed.


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      Anna Richmond, DNP, FNP-C, PNP-C, is an assistant professor at Vanderbilt University School of Nursing and a nurse practitioner at Monroe Carrell Jr. Children’s Hospital at Vanderbilt Department of Pediatric Rheumatology; she can be contacted at [email protected]


      Brittany Nelson, DNP, PNP-PC, is an assistant professor at Vanderbilt University School of Nursing and a nurse practitioner at Monroe Carrell Jr. Children’s Hospital at Vanderbilt Department of Pediatric Rheumatology.