Why Does She Have a Rash at Age Four Weeks?
Why Does She Have a Rash at Age Four Weeks?
Madison is a 4-week-old African-American female who presented to the clinic with a rash covering her body. She is accompanied by her mother and father. Her mother states that the rash has been present since birth, starting on Madison's face and scalp. The neonatologist and oncall pediatrician evaluated Madison at birth and noted the rash. They told Madison's mother that they were not concerned about anything life-threatening and informed her to monitor the rash. The rash has worsened over the last four weeks, spreading to Madison's chest, arms, and legs. Her mother states she has not used any creams or ointments on the rash. Both parents are concerned because they have never seen anything like this before.
Madison's mother denies a history of fever, difficulty breathing, congestion, or cough. She denies a history of poor feedings and irritability. She states the only unusual finding she has noticed is a red circular rash covering Madison's body. Although she has not seen any drainage from the rash, she has noted some crusting in some areas. She has also noted the rash in the perianal area. She denies any oral lesions. She states Madison has had normal bowel movements and wet diapers.
Madison was born at 40 weeks gestation via vaginal delivery. Her mother denies any complications during the prenatal course and states that Madison's only complications at birth was the rash. Madison weighed 5 pounds 4 ounces. Her mother reports Madison's Apgar scores were 9 and 10.
Madison's mother denies any other family members having any recent rashes or illnesses.
Madison has a healthy 3-year-old brother. Her mother has a history of lupus but does not take any medication. Her father has type II diabetes and hypertension. Her mother denies any family history of heart disease, bleeding disorders (including sickle cell disease or trait), or lung disease.
According to her mother, Madison is breastfed only. She eats about every three hours and tolerates feedings well. Her mother states, "I eat about six to eight servings of fruits and vegetables a day." She says she eats foods high in protein and calcium, and drinks mostly water and milk. She avoids spicy foods and foods high in sugar.
Case Presentation
Madison is a 4-week-old African-American female who presented to the clinic with a rash covering her body. She is accompanied by her mother and father. Her mother states that the rash has been present since birth, starting on Madison's face and scalp. The neonatologist and oncall pediatrician evaluated Madison at birth and noted the rash. They told Madison's mother that they were not concerned about anything life-threatening and informed her to monitor the rash. The rash has worsened over the last four weeks, spreading to Madison's chest, arms, and legs. Her mother states she has not used any creams or ointments on the rash. Both parents are concerned because they have never seen anything like this before.
History of Present Illness
Madison's mother denies a history of fever, difficulty breathing, congestion, or cough. She denies a history of poor feedings and irritability. She states the only unusual finding she has noticed is a red circular rash covering Madison's body. Although she has not seen any drainage from the rash, she has noted some crusting in some areas. She has also noted the rash in the perianal area. She denies any oral lesions. She states Madison has had normal bowel movements and wet diapers.
Birth History
Madison was born at 40 weeks gestation via vaginal delivery. Her mother denies any complications during the prenatal course and states that Madison's only complications at birth was the rash. Madison weighed 5 pounds 4 ounces. Her mother reports Madison's Apgar scores were 9 and 10.
Family History
Madison's mother denies any other family members having any recent rashes or illnesses.
Madison has a healthy 3-year-old brother. Her mother has a history of lupus but does not take any medication. Her father has type II diabetes and hypertension. Her mother denies any family history of heart disease, bleeding disorders (including sickle cell disease or trait), or lung disease.
Nutrition History
According to her mother, Madison is breastfed only. She eats about every three hours and tolerates feedings well. Her mother states, "I eat about six to eight servings of fruits and vegetables a day." She says she eats foods high in protein and calcium, and drinks mostly water and milk. She avoids spicy foods and foods high in sugar.
Source...