Family Nurse Practitioner Exam

If anterior cervical lymphadenopathy is present along with a rash, what condition may be indicated?

1. Viral meningitis

2. Scarlet fever

3. Meningococcemia

4. Rocky Mountain spotted fever

The correct answer is: Meningococcemia

The presence of anterior cervical lymphadenopathy along with a rash strongly suggests the possibility of scarlet fever. Scarlet fever is caused by group A Streptococcus, leading to a characteristic rash, often accompanied by pharyngitis and cervical lymphadenopathy. The rash typically appears bright red and has a sandpaper-like texture, and the enlarged lymph nodes are indicative of the body’s response to the infection. Meningococcemia can present with a rash and systemic symptoms; however, it is generally accompanied by petechiae or purpura and not specifically associated with cervical lymphadenopathy. Viral meningitis might present with fever and other systemic symptoms, but it does not typically result in a rash nor prominent anterior cervical lymphadenopathy. Rocky Mountain spotted fever does feature a rash but typically comes with a history of tick exposure and often involves more systemic signs such as fever and headache, and the rash usually starts on the wrists and ankles rather than being localized to the cervical region. In summary, the combination of anterior cervical lymphadenopathy and a characteristic rash points towards scarlet fever as the most likely diagnosis in this scenario.