You are a Junior Doctor working in a busy Accident and Emergency (A&E) on a sunny Saturday afternoon. You are covering the Paediatric A&E and many of your patients this afternoon seem to have had sporting injuries. As you refer your current patient to Orthopaedics you see a lady rush into triage carrying a little boy who is crying. The triage nurse asks you to see him immediately.
Tom is a 6 year old boy who has been brought in by his mother after his lips became red and swollen at a party this afternoon. As the nurse takes off his top to start her observations you also notice he has a rash consisting of red weals over his chest and back.
You try to get some more information from the mother while the nurse completes her observations. The mother seems very upset and worried but you manage to find out that they had been at a children's party. Tom had been playing in the garden with his friends and all the children had been having a picnic.
Tom had started to cry and said that his mouth felt funny so she brought him straight to A&E. She is not sure what he has eaten as there was a lot of different food and drink at the party. Tom has been otherwise well over the last few days and this has never happened before.