16yo Female presents to the office with a ‘splitting’ headache, fatigue, nausea

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16yo Female presents to the office with a ‘splitting’ headache, fatigue, nausea

16yo Female presents to the office with a ‘splitting’ headache, fatigue, nausea and myalgia. Pt’s mom reports that the illness started with a pin-prick rash on her hands, and is starting to spread. Physical exam shows high fever and a stiff neck.
Please describe 3 differential diagnosises and how you would rule them in or out.

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