We report the case of a 10-day-old Chinese girl with a 3-hour history of fever of 38 °C with no other symptoms.
Located with artificial feeding.
No family epidemic environment.
As a personal history, the pregnancy had maintained normal controls; it was a normal delivery without infectious risk factors, did not require resuscitation at birth and metabolic tests were pending at that time.
Physical examination showed good general condition, with no septic appearance, and normal results were obtained with equipment.
In the emergency department, a fever protocol without focus is initiated in a neonatal patient (blood, urinary and cerebrospinal fluid analysis normal) and empirical antibiotic therapy is prescribed.
The patient remains afflicted for 24 hours from admission to discharge, with no incidents except for maculopapular rash on the second day of admission, which resolves spontaneously in the following 24-48 hours.
suspected viriasis, and once the definitive results of cultures (negative) are confirmed, antibiotic therapy is suspended.
The discharge was decided at 15 days of life.
Two days later, the patient came to the Emergency Department complaining of a generalized rash of one day's evolution, with “daily” appearances with central clearance, elevated and confluent.
Loose color, more intense in the lower limbs, which is partially effaced by pressure, without petechiae.
As the only accompanying clinic, she had scarce liquid stools.
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The patient was kept under observation for 24 hours and, given the non-progression of the lesions and good general condition, discharge was decided.
After two days at home, the patient presented again with hypovolemic shock secondary to an abundant diarrhea for 18 hours, without vomiting or refusal to take food.
Cutaneous lesions had recurred.
No germ was isolated in the coprocultive and fecal virology was negative.
He received replacement with intravenous fluid therapy, which was withdrawn as oral tolerance improved with hydrolyzed milk and after ruling out intestinal involvement.
Depositions improved progressively and were discharged asymptomatic.
Follow-up visits showed adequate height gain, with normal consistency.
Feeding with hydrolyzed formula for a few weeks, with subsequent tolerance of artificial formula, without new skin lesions.
