Phone Visit
Narrative: SPRUCE MESSAGE VISIT Date: 2026-03-31 Encounter: Spruce text message with photo review (rash photos sent by parent) CC: Rash and itching following a gastrointestinal illness presumed to be norovirus. HPI: Charlie, age unknown, developed vomiting approximately 3 times over 12 hours (Saturday late afternoon through the middle of the night) in what the parent suspects was norovirus, which also affected the father. By the following evening (Monday), Charlie began experiencing itching and small rashes, which appeared more irritated due to scratching. There was no diarrhea or fever. The parent noted he had played hockey that evening and wondered if equipment pads may have contributed to the skin irritation. The family was departing for Florida the following morning for spring break. Assessment: Dr. Hobbs assessed the rash as likely a reactive/viral rash associated with the recent illness, noting it could come and go over the next few days. Hockey pads as an irritant were also considered but not the primary explanation. Plan: Recommended liquid Zyrtec (cetirizine) 5 mL once daily, using whichever antihistamine was available at home. Parent confirmed she had Zyrtec. Dr. Hobbs advised the rash may come and go over the next few days and to monitor. Medications: - Cetirizine (Zyrtec) 5 mL once daily (new) Key clinical quotes: "Likely some reaction to being sick. I'd give him either some liquid Benadryl or liquid Zyrtec. Whichever you have at home?" "They rash could come and go over the next few days." Source: Spruce conversation t_2GDBR8BFPUO00