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JAMA Clinical Challenge
January 14, 2019

A Fussy Infant With a Generalized Papulovesicular Rash

Author Affiliations
  • 1Department of Dermatology, Children’s Hospital Affiliated to Zhengzhou University, Zhengzhou, China
  • 2Department of Medical Education, Children’s Hospital Affiliated to Zhengzhou University, Zhengzhou, China
JAMA. 2019;321(6):604-605. doi:10.1001/jama.2018.20666

A 7-week-old, previously healthy full-term male infant presented with a 4-week history of a worsening, widespread, papulopustulovesicular eruption, which began as scattered papulovesicles over the chest. The infant was born to a 31-year-old mother by normal vaginal delivery. The mother had a benign prenatal course during pregnancy. Since the rash developed, the infant had been fussy with increasing restlessness at night. The parents denied any personal or family history of rash. On further questioning, the parents reported that the infant had had contact with a babysitter who reported pruritus, especially at night. The sitter had provided domestic care for the infant since birth until leaving that position 3 weeks earlier.