An 8-year-old child comes to the physician’s office complaining of swelling and pain in the knees. His mother says, “The swelling occurred for no reason, and it keeps getting worse.” The initial diagnosis is Lyme disease.
When talking to the mother and child, questions related to which of the following would be important to include in the initial history?
A . A decreased urinary output and flank pain
B . A fever of over 103F occurring over the last 2C3 weeks
C . Rashes covering the palms of the hands and the soles of the feet
D . Headaches, malaise, or sore throat
Answer: D
Explanation:
(A) Urinary tract symptoms are not commonly associated with Lyme disease.
(B) A fever of 103F is not characteristic of Lyme disease.
(C) The rash that is associated with Lyme diseasedoes not appear on the palms of the hands and the soles of the feet.
(D) Classic symptoms of Lyme disease include headache, malaise, fatigue, anorexia, stiff neck, generalized lymphadenopathy, splenomegaly, conjunctivitis, sore throat, abdominal pain, and cough.
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