Reference no: EM132470960

A 13 year old boy arrives in the ER with a rash that started on his arms and legs and now involves his palms and soles. He was seen by his doctor three days ago with a fever, headache, nausea and abdominal pain. He was diagnosed with acute gastroenteritis and sent home. His mother states the headaches, nausea and abdominal pain have persisted and that her son today has not "been himself." She is concerned that he is getting worse. He is awake and responsive, but appears ill. He has blanching, maculopapular rash on the extremities and palms and soles. There is some petechiae on his back and a small irregular healed scab on his left thigh which is moderately tender. He states he picked up a tick about a week ago while hiking. He removed it by squeezing and scratching which caused the scab. His lungs are clear, and he is not in respiratory distress. Labs show a mildly elevated white cell count. What is the likely diagnosis and standard first line of treatment? What is the etiologic agent? What are the serious complications?