Conversation: The conversation between human and AI assistant.
[|Human|] my 6 year old daughter has tested positive for strep twice now and is on her 2nd round of antibiotics, she has complained of severe abdominal pain and is now having nosebleeds. She had been complaining of the abdominal pain before this 2nd round of antibiotics, but now has the nosebleeds. At the start of this she had sudden onset of abd. pain, with fever , vomiting, grey skin color, heart rate was in the 160 s. We went to the ER for this and she was started on the 2nd antibiotic there through IV, and responded well to this. I am still confused over the abdominal pain and nosebleeds.
[|AI|]  Hi.... Can you describe the complaints in details? Does the child have history of nose picking? Is there underlying Cory like symptoms? Nose bleed can most commonly be due to nose picking or can be a manifestation of underlying bleeding disorders. As it is associated with the abdominal pain and fever we should also think about infective etiologies like dengue where the patient has high grade fever, rash, epistaxis, Aldo pain can be associated. Other possibility is that this nose bleeding may be different from abdominal pain. I think the child will need few investigations such as hologram to look for platelet count and bleeding and clotting time. Also, please let me know how is the abdominal pain and fever at present?