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JAMA Pediatrics Clinical Challenge
February 2016

Three-Day-Old Boy With Palmar Pustules

Author Affiliations
  • 1Department of Dermatology, University of California, San Francisco
  • 2currently with The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York
  • 3currently with Department of Dermatology, Mayo Clinic, Rochester, Minnesota
JAMA Pediatr. 2016;170(2):171-172. doi:10.1001/jamapediatrics.2015.1996

A 3-day-old full-term male infant was transferred to our hospital from an outside neonatal intensive care unit for a concern of systemic infection in the setting of newly noted numerous right palmar pustules. The infant was the product of a 41-week-and-5-day gestation, to a group B streptococcus–positive mother. The pregnancy was otherwise uneventful. A cesarean delivery was performed because of failure to progress and concern for chorioamnionitis, as the mother was febrile during labor. The infant was 4025 g with Apgar scores of 2, 7, and 9 at 1, 5, and 10 minutes, respectively. Given concern for maternal fever, he had blood cultures drawn and started receiving ampicillin and gentamicin.

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