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June 1997

Picture of the Month

Author Affiliations

From the Department of Pediatrics, University of Texas, Southwestern Medical Center at Dallas.

Arch Pediatr Adolesc Med. 1997;151(6):625-626. doi:10.1001/archpedi.1997.02170430091019

AT THE time of her adoption in China, where she had been in an orphanage since 6 weeks of age, this 6-month-old girl had a fever (temperature, 38.8°C) and several large, red swellings on her scalp. A local physician began treatment with oral erythromycin and topical mupirocin ointment with no improvement in her condition.

When the infant arrived in the United States 9 days later, the scalp lesions had enlarged and coalesced with spontaneous drainage of blood and purulent material (Figure). She continued to have a low-grade fever.

Denouement and Discussion 

Folliculitis, Furunculosis, and Carbuncles  Top, Multiple circumscribed erythematous nodules are present on the scalp with thin, tense overlying skin and central fluctuation representing furuncles. Center, Large, boggy, erythematous areas representing the coalescence of furuncles with multiple drainage sites are typical of carbuncles. Bottom, A close-up view of a carbuncle demonstrating loculated abscesses with pus and bloody drainage.Folliculitis, furunculosis,