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JAMA Pediatrics Clinical Challenge
September 2017

Neonate With Cutaneous Vesicles and Respiratory Distress

Author Affiliations
  • 1Department of Dermatology and Cutaneous Surgery, Jackson Memorial Hospital/University of Miami Miller School of Medicine, Miami, Florida
  • 2Department of Dermatology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
JAMA Pediatr. 2017;171(9):909-910. doi:10.1001/jamapediatrics.2017.1207

A 3-day-old premature male infant, born at 26 weeks’ gestational age, presented to the dermatology department with a skin rash on the bilateral lower extremities. History was notable for preterm premature rupture of membranes for 10 days. The neonate was born via urgent cesarean delivery owing to breech positioning. The mother was otherwise in good health with normal prenatal care and had no history of sexually transmitted diseases. During the first few days of life, the neonate had recurrent hypoxic episodes. He was receiving intravenous antibiotics for suspected sepsis and bacitracin for the topical lesions. Per the primary team, the rash was first noted at 3 days of life.

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