Can you describe the rash?

On further questioning – the patient has not had a fever and there is no arthalgia.

Obviously the GPs first concern is meningitis, however on review there are no signs of meningism.

His mother thinks the rash may have been present for a few days, but became significantly worse today.  She volunteers that the child has not been himself for a few days, however does not report any other specific symptoms.

Any other specific questions you may wish to ask? further examination?

You plan to take some blood tests. How urgently?  Do you continue to manage him in the community?

What is your differential at this point?