FA Nettles, MD; Benjamin Estrada, MD; Judy V. Blair-Elortegui, MD; Roberto Gordillo, MD, Daran Mason, MDSeries Editors: Sheryl Falkos, MD, and Rosa A. Vidal, MD


October 25, 2005


A 3-year-old white toddler was in her normal state of good health until 5 days prior to hospital admission, when the mother noticed a red rash developing on the child's back, at the level of the top of her shorts. It was initially thought that the rash was caused by recent sun exposure. However, due to the child's worsening condition, she was taken to her primary care physician the following day for evaluation. She was treated with cephalexin, diphenhydramine, and a 3-day course of corticosteroids.

Three days prior to admission, she was taken to the Children's Evaluation Center because her rash had continued to worsen, and she was sent home on the same treatment. She presented on the day of hospital admission with a persistently worsening rash and concurrent pain. Further questioning revealed recent upper respiratory infection symptoms of cough and rhinorrhea, occurring 2 days prior to the appearance of the rash.

A review of systems was negative for recent ingestions, recent medications, fever, chills, nausea, vomiting, diarrhea, constipation, joint swelling or pain, or change in activity.


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