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NeoReviews Vol.8 No.5 2007 e222
© 2007 American Academy of Pediatrics

Index of Suspicion in the Nursery

The first 20% of the full text of this article appears below.


   Case Presentation
 
At birth, an otherwise healthy boy has blueberry muffin nodularlike lesions measuring 0.5x0.5 cm at his right postauricular area, left neck skinfold, thigh, and groin (Fig. 1). He also has a 0.5x0.5 cm pustule on the dorsum of the foot (Fig. 2). The infant has crusty lesions on the left side of his lip (Fig. 3) and eyebrow, smaller bluish papules measuring 0.25x0.25 cm (two on the back [Fig. 4] and one at the preauricular area [Fig. 5]), and two petechial lesions on the right frontal area. The rest of the physical examination findings are within normal limits.


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  		Figure 1. Blueberry muffin macules on the thigh and groin.

 

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  		Figure 2. Erythematous vesicular lesion on the dorsum of baby's foot.

 

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  		Figure 3. Crusted erythematous vesiculopustular lesion on the upper lip.

 

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  		Figure 4. Two erythematous macules on the back of the infant.

 

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  		Figure 5. Pre- and postauricular erythematous nodules.

 
The infant was born to a 24-year-old G4P1 woman at 38–1/7 weeks' gestation. The mother has a history of smoking 1 pack of cigarettes per day during pregnancy. Apgar scores are 9 at both 1 and 5 minutes. Screening reveals blood group O+, hepatitis B surface antigen-negative, rubella immune, rapid plasma reagin-nonreactive, human immunodeficiency virus-negative, and group B Streptococcus-negative.

Initial laboratory analysis for the infant reveals a high white blood cell count with a left shift, elevated aspartate aminotransferase (124 U/L) and lactate dehydrogenase (1,299 U/L), and a normal C-reactive protein concentration. Gram . . . [Full Text of this Article]

Hassan Ibrahim, MD
Guillermo Sangster, MD
Margaret E. Hollister, MD
Hilary Tice, PharmD
Enrique Gonzalez, MD
Diana Bienvenu, MD

Department of Pediatrics, Louisiana State University Health Science Center-Shreveport, Shreveport, La






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Copyright © 2007 by the American Academy of Pediatrics.