Wednesday, February 28, 2007

Derm round 22



13 months old baby boy was admitted to the ward for prolonged fever. Clinically, he has hepato-splenomegaly. Full blood count showed pancytopenia. Peripheral blood film and the bone marrow aspirate were unremarkable. "Biohazard" screenings were all negative. Blood C&S has no growth and the rest of the investigations were unremarkable.

He was treated empirically with IV antibiotic (Cloxacillin and Ceftriaxone). After one week in the ward, and the temperature was still spiking, he developed numerous small papular lesions over the body and more marked over the lower limbs.

On examination, there were monomorphic, skin-colored, small papular eruptions, scattered over the face, body, upper limbs and numerously over the lower limbs (see pictures).

What is it?
We were thinking, more of molluscum contagiosum.

But the paediatricians thought otherwise, ? Gianotti-Crosti syndrome.

See:
eMedicine
DermNet NZ

1 comment:

Dr. David Teoh said...

But how to explain the hepatosplenomegaly? Is it big?

Is the patient ill?

I would consider histiocytosis X as a differential.