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Male Infant With Rapidly Progressive Skin Lesions
IMAGES IN EMERGENCY MEDICINE Chao-Hsu Lin, MD; Szu-Chia Lee, MD; Yih-Cherng Duh, MD; Chi-Hone Lien, MD; Yu-Hsiang Sung, MD; Chien-Yu Lin, MD 0196-0644/$-see front matter Copyright © 2017 by the American College of Emergency Physicians. http://dx.doi.org/10.1016/j.annemergmed.2017.01.043
Figure 1. Initial appearance showing purpuric lesions with surrounding erythema over the right thigh and buttock.
Figure 2. The buttock lesion evolved into a gangrenous eschar with a central dusky necrosis, followed by a surrounding halo 12 hours later.
Figure 3. The necrotic eschar became mature and sloughed 7 days later.
[Ann Emerg Med. 2017;70:103.] A 7-month-old male infant presented with fever for 2 days and rash for 1 day. The patient had received a diagnosis of croup 1 week before admission. Physical examination revealed hypotension and purpuric lesions with surrounding erythema over the right thigh and buttock (Figure 1). Laboratory testing revealed anemia, neutropenia, and hyponatremia. The buttock lesion evolved into a gangrenous eschar with a central dusky necrosis, followed by a surrounding halo 12 hours later (Figure 2).
For the diagnosis and teaching points, see page 109. To view the entire collection of Images in Emergency Medicine, visit www.annemergmed.com Volume 70, no. 1 : July 2017
Annals of Emergency Medicine 103
Correspondence 2. LaMantia MA, Platts-Mills TF. Bending the curve of health trajectories for older adults discharged from the emergency department. Ann Emerg Med. 2017;69:434-436. 3. American College of Emergency Physicians; American Geriatrics S, Emergency Nurses A, Society for Academic Emergency M, Geriatric Emergency Department Guidelines Task F. Geriatric emergency department guidelines. Ann Emerg Med. 2014;63:e7-e25.
Volume 70, no. 1 : July 2017
4. Brown CJ, Kennedy RE, Lo AX, et al. Impact of emergency department visits and hospitalization on mobility among community-dwelling older adults. Am J Med. 2016;129:1124.e9-1124.e15. 5. Lo AX, Flood KL, Biese K, et al. Factors associated with hospital admission for older adults receiving care in United States emergency departments. J Gerontol. 2016; http://dx.doi.org/10.1093/gerona/ glw207.
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Figure 1. Initial appearance showing purpuric lesions with surrounding erythema over the right thigh and buttock.
Figure 2. The buttock lesion evolved into a gangrenous eschar with a central dusky necrosis, followed by a surrounding halo 12 hours later.
Figure 3. The necrotic eschar became mature and sloughed 7 days later.
[Ann Emerg Med. 2017;70:103.] A 7-month-old male infant presented with fever for 2 days and rash for 1 day. The patient had received a diagnosis of croup 1 week before admission. Physical examination revealed hypotension and purpuric lesions with surrounding erythema over the right thigh and buttock (Figure 1). Laboratory testing revealed anemia, neutropenia, and hyponatremia. The buttock lesion evolved into a gangrenous eschar with a central dusky necrosis, followed by a surrounding halo 12 hours later (Figure 2).
For the diagnosis and teaching points, see page 109. To view the entire collection of Images in Emergency Medicine, visit www.annemergmed.com Volume 70, no. 1 : July 2017
Annals of Emergency Medicine 103
Correspondence 2. LaMantia MA, Platts-Mills TF. Bending the curve of health trajectories for older adults discharged from the emergency department. Ann Emerg Med. 2017;69:434-436. 3. American College of Emergency Physicians; American Geriatrics S, Emergency Nurses A, Society for Academic Emergency M, Geriatric Emergency Department Guidelines Task F. Geriatric emergency department guidelines. Ann Emerg Med. 2014;63:e7-e25.
Volume 70, no. 1 : July 2017
4. Brown CJ, Kennedy RE, Lo AX, et al. Impact of emergency department visits and hospitalization on mobility among community-dwelling older adults. Am J Med. 2016;129:1124.e9-1124.e15. 5. Lo AX, Flood KL, Biese K, et al. Factors associated with hospital admission for older adults receiving care in United States emergency departments. J Gerontol. 2016; http://dx.doi.org/10.1093/gerona/ glw207.
Annals of Emergency Medicine 109