A 3-month-old infant with low-grade fever and rash ( Page 1/1)
Prepared by...
Virat Sirisanthana, M.D.
Department of Pediatrics, Chiang Mai University
 
CC: Low -grade fever with rash for several days.
PH: Since he was abandoned by his parents when he was born, his past history was unknown.
PI: He started having low-grade fever several days ago. He was less active on the day of
admission. The nursemaid at the abandon-child-home noticed several spots of skin lesions a
week ago.
 
PE: Body temp was 38 C. Other vital signs were within normal limits.
Skin: There were 3 crops of skin lesions at the chest wall and back as shown in the figures (1-4).
The nursemaid described the first crop was the at the Lt. posterior chest wall, the second was at
the Rt. posterior chest wall and the last crop was at Lt. anterior chest wall.
Other systems: were within normal limits.
 
Figure 1
Figure 2
l-post-1.jpg (15522 bytes)
L-R-post-1.jpg (16163 bytes)
   
Figure 3
Figure 4
r-post-1.jpg (16277 bytes)
l-ant-2.jpg (14511 bytes)
   
  Investigation: Scraping from the base of the fresh vesicular lesion yielded multinucleated giant
cells with Wright Stain.
   
  Course in the hospital:
He was started on oral acyclovir. The skin lesions and fever gradually subsided.
   
  Diagnosis: Herpes zoster
   
  Further Readings: See Short Interesting Case No. 2

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