6/25- Elliott is given the following vaccines: HepA, MMR, Prevnar 13, VAR (Varicella)
7/3- Elliott has a fever of 102.5, lethargic, fussy. CBC indicates likely viral infection.
7/5- Elliott has a red, pin prick- like flat rash on his trunk and genitals that spread to entire body within hours. Fever of 100.6.
7/7- Rash and fever are gone.
7/11- E has diarrhea with awful diaper burn and is fussy buns (as one would expect).
7/12- Diarrhea continues, now with fever. See new pedi. Diagnoses him with gastroenteritis.
7/14- Fever gone, diaper burn gone, no more big D.
7/17- Elliott slept all day. Very irregular. No fever.
7/18- Fever returns, lethargic, Rash- begins as tiny pin prick- like raised dots on lower abdomen and groin. Within hours, it had spread to chest, back and upper thighs. Pedi examines him and gives diagnosis of Enterovirus.
7/19- Fever spikes to 103F. Rash worsens. Dots are now raised and all over body, including face.
7/20- Fever continues to run 102. Drops to 99.5-100 with Tylenol. Back to pedi. Blood work indicates: Elevated hemoglobin and hematocrit, elevated white blood count, normal electrolytes. Blood culture to be completed by morning. Pedi noted blood work corroborates enterovirus. suggested Benedryl for rash, continue Tylenol.
7/21- E is miserable and rash worsens. He is refusing liquids, and solids (hasn't eaten much in terms of solids for weeks- during all of these bouts). Here are pictures of the rash:
You can really see the topography in the below picture. I should also note that the rash does turn white upon pressure.
Is this really just part of enterovirus? It looks nothing like examples I have seen of enteroviral rashes. It looks a lot like measles. Reactions to MMR are typically within 14 days, but can occur up to 28 days following the vaccine. Is it typical to have 2 separate reactions to MMR? His symptoms are:
-Fever (now down to 99-100)
-Discomfort, picking and scratching at rash
-seemingly sore throat- red and irritated on exam
-refusal to eat or drink (has had maybe 12 oz of fluids-water, formula, Gatorade G2- since midnight)
-irritable
He doesn't have any other symptoms. Respiratory rate is fine, Heart rate is in 120s (fine), no diarrhea during this particular spell.
Any ideas?
Did you ever get an answer?
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