Test your skills: A worsening rash
A 5-year-old boy has a rash on his legs and says it hurts to walk. What’s your diagnosis?
You see the child again in 3 days, by which time his arthralgias are improving. Repeat urinalysis shows continuing moderate blood and trace protein. You follow him biweekly for 2 weeks, and then weekly for 4 more weeks. Six weeks after his initial presentation, his symptoms completely resolve, and urinalysis shows no evidence of hematuria or proteinuria. His blood pressure is normal at all visits.
You see the patient monthly for the next 5 months. Symptoms do not recur, and urinalysis results are normal. You counsel the boy’s mother regarding the risk of recurrence, and advise her to contact the office immediately if symptoms return.
CORRESPONDENCE Shailendra K. Saxena, MD, PhD, Department of Family Medicine, 10828 John Galt Boulevard, Omaha, NE 68137; ssaxena820@gmail.com
