Medical Challenge Case

Case: Shadows


S: Edwin is a newborn baby weighing 4 pounds 11oz. Mother reports not being sick a single day. There was no vomiting, diarrhea, fever, colds or rashes reported by the mother during pregnancy.  

O: Patient was breathing without difficulty, moving arms and legs symmetrically, one side mirroring the other. Head and facial features were of normal size and shape, neck and trunk looked perfect. Other than his small size and enlarged liver and spleen, the baby seemed perfectly normal. Blood work revealed anemia and elevated bilirubin. Patient was placed on phototherapy. The phototherapy consists of placing the baby under special florescent lights to stimulate a chemical reaction that speeds bilirubin breakdown in the blood stream. However, the baby developed a very strange rash with phototherapy, which consists of blistering all over the body. The blisters were larger than a quarter in size and when rubbed, they wept clear fluid. The baby now was crying and appeared to be suffering from the blisters. The bullae appeared from head to toe except for areas that had been covered from waist to scrotum and the back. Wood’s Lamp examination caused the diaper to emit a bright red glow. 


A: What is your diagnosis of this patient?

P: What is your recommended plan of treatment?