3 week old with a "rash"

Message from Jill Stoller hidden@email-address

I absolutely think you could get this type of rash from cow's milk
protein allergy. I would put the baby on an elemental formula and
observe. Get stool for occult blood. Stool smear for eos (look for
peripheral eosinophilia). Would love to see the rash if you have a
digital camera.

Jill Stoller, MD
New Jersey

On Monday, June 20, 2005, at 09:51 PM, Valerie Welch wrote:

> 21 day old infant comes in my office tonight with a rash that looks
> urticarial--patchy, red to purple lesions, blanching with slight
> edema. If I'd
> seen this in the nursery, I would have thought erythema toxicum...but
> it only
> started today and the kid is 3 weeks old.
> Breast-feeding "6 or 7 times a day" but "still seems hungry"...getting
> about 6
> oz/day of Enfamil. Birth wt 8 #13; 2 week check-up wt. 7#13. (PMD,
> according
> to mom, "just told me to keep breast-feeding".) Today's weight--7#14
> ounces.
> Baby is lively and pink; not the greatest body fat in the world, but
> not
> dehydrated. Peeing and pooping fine; some spits which have become more
> forceful over past 24 hours. Afebrile. Mom swears he's been inside the
> whole
> time and has not been mosquito-bitten...but this is Minnesota....
> I'm thinking enterovirus at the top of my differential. Can you see
> allergy-induced urticaria in this young of an infant, possibly
> reacting to
> cow's milk protein? Would erythema toxicum even be a consideration
> this far
> out? Would you give him Benadryl (I'm observing him in the hospital
> overnight
> while I get labs.)
> Any ideas would be great! I can e-mail photos of the rash if you want.
>
> [demime 1.01d removed an attachment of type image/gif which had a name
> of Ivy.gif]
>

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