Step I spoiler: nbme 18 question

[dontwantaids]

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Hey guys, one of the questions of NBME 18 section 1 was as follows: child with large flaccid bullae over trunk and abdomen, fever (102), bp110/60. People in diffeent forums are suggesting that it's toxic shock syndrome. However, this child doesn't have shock; desquamation is the more common dermatological manifestation rather than bullae; no end-organ problems or vomiting; toxic shock syndrome doesn't classically occur in children, but in women using tempons. So I am wondering if it's choice a: eosinophilia (i.e. atopic dermatitis). What do you guys think?

 

[dontwantaids]

on the other hand, there are some strong points against atopic dermatitis: no mention of pruritus, recurrency; fever/bullae are not classic for atopic dermatitis

 

[6FFF]

I went with the staph aureus/toxic shock syndrome answer (can't remember specifics) and it didn't show up in my incorrects. I agree that the bullous manifestation doesn't seem to align with the classic desquamative rash, but it was the "best" answer of the choices from what I remember

 

[dontwantaids]

I went with the staph aureus/toxic shock syndrome answer (can't remember specifics) and it didn't show up in my incorrects. I agree that the bullous manifestation doesn't seem to align with the classic desquamative rash, but it was the "best" answer of the choices from what I remember

Hey, thanks a million! This is such an unusual presentation, including the normal BP!

 

[Iceandmedicine]

I think it was Staph Aureus - Scalded Skin Syndrome

 

[dontwantaids]

I think it was Staph Aureus - Scalded Skin Syndrome

yea, that makes a lot more sense. sss also has positive nikolsky, fever, etc. Thanks!