Phone Visit
Narrative: SPRUCE MESSAGE VISIT Date: 2025-12-05 Encounter: Spruce text message with photo review (rash images sent by parent) CC: School-age child with several days of fever, cough, vomiting, leg pain, and new rash. HPI: Luke is a school-age boy who began having symptoms on Wednesday including mild fever, productive/juicy cough, fatigue, and two episodes of vomiting (thought to be mucus-related). By Thursday symptoms improved during the day but fever returned overnight along with a new rash. On Friday (day of message) he continued to have mild fever (101°F), rash, fatigue, and leg pain. He had no complaint of sore throat. Motrin was given at home with improvement. Photos of the rash were shared with Dr. Hobbs. Assessment: Presentation most consistent with a viral illness. Rash not worrisome on photo review. No sore throat to suggest strep. Fever of 101°F not at a level of clinical concern. Plan: Reassurance provided. Parent educated that a temperature of 104.5°F is a concerning threshold from a pure number standpoint, but overall clinical appearance matters most. Continue supportive care with Motrin as needed. No prescription or further workup indicated. Key clinical quotes: "The rash isn't too worrisome. How high was that fever? Any sore throat" "All likely viral (sorry for the delay, had a couple of appts)" "From a pure number standpoint, 104.5. But it matters the most how someone is doing" Source: Spruce conversation t_2GDBR8BFPUO00