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Neonate With Cutaneous Vesicles and Respiratory Distress
JAMA Pediatrics ( IF 24.7 ) Pub Date : 2017-09-01 , DOI: 10.1001/jamapediatrics.2017.1207 Kate E. Oberlin 1 , Erin X. Wei 2 , George W. Elgart 1
JAMA Pediatrics ( IF 24.7 ) Pub Date : 2017-09-01 , DOI: 10.1001/jamapediatrics.2017.1207 Kate E. Oberlin 1 , Erin X. Wei 2 , George W. Elgart 1
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A 3-day-old premature male infant, born at 26 weeks’ gestational age, presented to the dermatology department with a skin rash on the bilateral lower extremities. History was notable for preterm premature rupture of membranes for 10 days. The neonate was born via urgent cesarean delivery owing to breech positioning. The mother was otherwise in good health with normal prenatal care and had no history of sexually transmitted diseases. During the first few days of life, the neonate had recurrent hypoxic episodes. He was receiving intravenous antibiotics for suspected sepsis and bacitracin for the topical lesions. Per the primary team, the rash was first noted at 3 days of life. Physical examination demonstrated a small, ill-appearing neonate with multiple, grouped vesicles and punched-out ulcerations on his scalp, axilla, extremities, and scrotum (Figure, A-D). He also had witnessed respiratory desaturations requiring urgent intubation. Initial laboratory evaluation demonstrated a normal complete blood cell count and serum chemistry with the exception of a high lymphocyte count (34%, normal level <25% [to convert to proportion of 1.0, multiply by 0.01]) and high aspartate aminotransferase level (117 IU/L, normal level 8-39 IU/L [to convert to microkatals per liter, multiply by 0.0167]). A chest radiograph demonstrated increased pulmonary markings bilaterally. Scalp and face A
中文翻译：
有皮囊和呼吸窘迫的新生儿
一名 3 天大早产男婴，出生于 26 周胎龄，因双下肢皮疹就诊于皮肤科。历史上值得注意的是胎膜早破 10 天。由于臀位定位，新生儿通过紧急剖宫产出生。母亲身体健康，产前护理正常，没有性传播疾病史。在生命的最初几天，新生儿反复出现缺氧发作。他因疑似败血症接受静脉注射抗生素，局部病变接受杆菌肽治疗。根据初级团队，皮疹是在出生后第 3 天首次发现的。体格检查显示，一个外观不佳的小新生儿，头皮、腋窝、四肢、和阴囊（图，AD）。他还目睹了需要紧急插管的呼吸饱和度下降。初步实验室评估表明，除淋巴细胞计数高（34%，正常水平 <25% [转换为 1.0，乘以 0.01]）和高天冬氨酸转氨酶水平（117 IU/L，正常水平 8-39 IU/L [转换为每升微量，乘以 0.0167]）。胸片显示双侧肺纹理增加。头皮和脸A 乘以 0.01]）和高天冬氨酸转氨酶水平（117 IU/L，正常水平 8-39 IU/L [转换为每升微量钾，乘以 0.0167]）。胸片显示双侧肺纹理增加。头皮和脸A 乘以 0.01]）和高天冬氨酸转氨酶水平（117 IU/L，正常水平 8-39 IU/L [转换为每升微量钾，乘以 0.0167]）。胸片显示双侧肺纹理增加。头皮和脸A
更新日期：2017-09-01
中文翻译：
有皮囊和呼吸窘迫的新生儿
一名 3 天大早产男婴，出生于 26 周胎龄，因双下肢皮疹就诊于皮肤科。历史上值得注意的是胎膜早破 10 天。由于臀位定位，新生儿通过紧急剖宫产出生。母亲身体健康，产前护理正常，没有性传播疾病史。在生命的最初几天，新生儿反复出现缺氧发作。他因疑似败血症接受静脉注射抗生素，局部病变接受杆菌肽治疗。根据初级团队，皮疹是在出生后第 3 天首次发现的。体格检查显示，一个外观不佳的小新生儿，头皮、腋窝、四肢、和阴囊（图，AD）。他还目睹了需要紧急插管的呼吸饱和度下降。初步实验室评估表明，除淋巴细胞计数高（34%，正常水平 <25% [转换为 1.0，乘以 0.01]）和高天冬氨酸转氨酶水平（117 IU/L，正常水平 8-39 IU/L [转换为每升微量，乘以 0.0167]）。胸片显示双侧肺纹理增加。头皮和脸A 乘以 0.01]）和高天冬氨酸转氨酶水平（117 IU/L，正常水平 8-39 IU/L [转换为每升微量钾，乘以 0.0167]）。胸片显示双侧肺纹理增加。头皮和脸A 乘以 0.01]）和高天冬氨酸转氨酶水平（117 IU/L，正常水平 8-39 IU/L [转换为每升微量钾，乘以 0.0167]）。胸片显示双侧肺纹理增加。头皮和脸A
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