Review Question - QID 213226

A 5-year-old boy presents to the emergency department with a rash. The patient’s parents state that he has been more ill lately. They report that he recently developed a rash on his head that now seems to be spreading to the rest of his body. His symptoms started 3 days ago and have considerably worsened since then. The patient is otherwise healthy. He has not seen a pediatrician nor has he attended general checkup or milestone appointments. The patient’s parents have tried giving him homeopathic remedies including tuber oil to help him feel better with little success. Otherwise, the parents regularly take their child hiking and swimming in outdoor streams. His temperature is 102°F (38.9°C), blood pressure is 106/68 mmHg, pulse is 167/min, respirations are 25/min, and oxygen saturation is 99% on room air. Physical exam is notable for the finding in Figure A. The child appears very ill and confused. Which of the following is the most likely diagnosis?