Mrs B's 15-year-old son, Boy X, is a healthy grade 9 learner. Two days ago he started complaining about not feeling well. At first she wasn't too concerned, thinking that the boy was just tired from school and sport every afternoon.
When he developed a persistent fever of more than 39 degrees, Mrs B became more worried. Boy X also complained of headache, earache and joint pains. The headaches became progressively worse with lethargy and "neck pain". While taking his temperature, she noticed small bruise-like marks covering his upper body and arms. She asked her son what this was and he said it might have been caused by tackling during rugby practice.
Mrs B gave Boy X fever medication and tucked him into bed.
The next morning she became really concerned when she found Boy X drenched in sweat, very irritable, vomiting profusely and speaking unintelligibly. He also did not want her to put on the bedroom light.
Not knowing what was wrong with her son, Mrs B took him to the doctor.
Given the above information, what is the most likely diagnosis? What will the doctor most likely find on examination? What would the management of his condition entail?
What's your diagnosis? Join the guesswork on our Facebook page, or comment below.
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Previously on What's Your Diagnosis?
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What's your diagnosis? - Case 18: boy with persistent fever
What's your diagnosis? – Case 19: lady who can't lose weight
What's your diagnosis? – Case 20: chest pain next to breastbone
What's your diagnosis? – Case 21: burning sensation in vagina
Image: Boy with headache from Shutterstock