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May 2016

Cutaneous Presentation of Methicillin-Resistant Staphylococcus aureus Sepsis in a Healthy Child

Author Affiliations
  • 1Department of Dermatology, University of Louisville School of Medicine, Louisville, Kentucky
JAMA Dermatol. 2016;152(5):580-582. doi:10.1001/jamadermatol.2015.5367

Septic vasculopathy is a life-threatening condition that can present with cutaneous findings. We present a case of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) sepsis presenting as 2 retiform purpuric patches and diffuse erythematous to violaceous papules.

A healthy male toddler presented to the emergency department with abdominal pain and distention, fever, and vomiting of 1 day’s duration. He was found to have “bruises” on both flanks (Figure 1A). Workup for child abuse was initiated, and he was treated with enemas for constipation and intramuscular penicillin after positive streptococcal findings. Over the next 2 days, he developed diffuse papules on the trunk and extremities; his condition rapidly deteriorated requiring intubation, vasopressors, and empirical broad-spectrum antibiotics. A dermatology consult was obtained to evaluate his skin eruption.

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