ACEP ID:

Pediatric Emergency Medicine

Case Study of the Month-July

Rosemary Thomas-Mohtat, MD 

Mohsen Saidinejad, MD, MBA 

Children’s National Medical Center 

The patient has been afebrile, feeding well, and has been voiding and stooling normally. No history of vomiting is reported. She is currently being treated for oral thrush and a diaper rash with oral and topical nystatin. No maternal history of group B streptococcus or any perinatal infection is noted.  

 Physical examination in the ED: Vitals: T 37.5oC rectal, Pulse: 140/min, Respiratory rate: 44/min, Blood pressure: 91/58, pulse oximetry: 96%    

 The patient is well appearing and active. Few thick white plaques are noted on the buccal mucosa. The palmar rash is shown here. 

  July case image  

What is the best management approach for this patient?

 

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