1. Question 1

* 1. A 12-year-old girl who stepped on a nail 3 days ago has redness and swelling of the right foot. She also has a 1-day history of fever, vomiting, headache, myalgias of the legs, and a confluent, erythematous rash on her face and back.

Temperature is 39.1°C, pulse rate is 145/min, respiratory rate is 36/min, and blood pressure is 83/35 mm Hg. The conjunctivae are erythematous, and she has an erythematous macular rash on her face and upper back. Examination of the right foot reveals a puncture wound on the plantar surface, with a purulent exudate.

Which of the following is the most likely diagnosis?