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Pustules and Red Bumps on the Axillae and Abdomen of a 5-Week-Old Infant
John W. Harrington, MD
Director, Division of General Academic Pediatrics, Children’s Hospital of The King’s Daughters, Norfolk, VA
Harrington JW. Pustules and red bumps on the axillae and abdomen of a 5-week-old infant. Consultant. Published online August 4, 2021. doi:10.25270/con.2021.08.00002
The author reports no relevant financial relationships.
John W. Harrington, MD, 601 Children's Lane, Norfolk, VA 23507 (John.Harrington@chkd.org)
A 5-week-old infant presented with his parents to our outpatient pediatric facility with pustules and red bumps clustered on the right axillae and scattered on the abdomen (Figure). The patient’s parents only spoke Spanish and had recently emigrated from Honduras.
Figure. Pustules and red bumps were noted on the right axillae and scattered on the abdomen.
The initial practitioner’s concern was for a possible skin infection or varicella, but there was no known exposure to varicella. At presentation, the infant was irritable but afebrile. The decision was made to admit the infant to the hospital.
A partial sepsis workup was conducted, results of which revealed a complete blood cell count in the normal range. Swabs were taken from an unroofed pustule, and polymerase chain reaction tests for herpes simplex virus 1 and 2 were conducted, results of which were negative. Results of blood and urine cultures were also negative, and inflammatory marker levels in the normal range.
Intravenous clindamycin was initiated and then was switched to oral medication upon discharge. The patient and his parents followed up on the fifth day of antibiotics, at which time, the rash was unimproved and spreading to the back of the patient’s neck.
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