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Picture of the Month—Quiz Case
Dirk E. Bock, MD;
Victor Prabhakaran, MD, FRCPC;
Guido Filler, MD, PhD, FRCPC
Arch Pediatr Adolesc Med. 2009;163(8):765.
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A 7-month-old boy had a 3-week history of nonbloody diarrhea and increasing irritability. The mother reported a perioral and anogenital erythematous rash that first appeared in the third month of life with variable severity but never resolved. In the 4 months prior to admission, various visits to family doctors and hospitals with multiple courses of oral antibiotic treatments and different ointments led only to brief improvements of the skin condition with subsequent relapses. A trial with corticosteroids for suspected psoriasis caused a severe deterioration. The perinatal history was noncontributory: the boy was born at term after an unremarkable pregnancy, was fully breastfed, and developed appropriately along the 75th percentile for height and weight.
On admission, the child was afebrile (rectal temperature, 37.1°C) with all vital signs within normal limits, but he was irritable and crying a lot. . . . [Full Text of this Article]
Author Affiliations: Department of Pediatrics, Children's Hospital (Drs Bock and Filler) and Departments of Pathology and Laboratory Medicine (Dr Prabhakaran), London Health Science Center, University of Western Ontario, London, Ontario, Canada.
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