ACEP ID:

Pediatric Emergency Medicine

Case Study of the Month-March

A four-week-old male presents to the ED with the rash shown.  The mother states that the rash began as a small “bump” on the left shoulder the day before, and it has progressed to its current size. No history of fever, fussiness, or change in feeding is reported.  The patient was born full term, and no perinatal complications were reported.

On examination, the baby is alert and feeding vigorously. He has no other rashes or lesions on his skin. His vitals are as follows: T 36.9°C (rectal), HR 118, RR 28, BP 96/68. A soft blanching area of erythema and induration, measuring 3 cm x 6 cm is noted on the left shoulder. The area is not fully fluctuant, but has a more firm central area. No cutaneous involvement of the neck or any cervical lymphadenopathy is noted. Which of the following would be your preferred approach for management of this patient?
 Peds March Case Study 1  

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