A 6-month-old African American boy presented to the emergency department (ED) with a rash first noted on his face, spreading to his torso and extremities over 2 days. He had no history of fever or new exposures, and the rash appeared to be pruritic. A review of systems was positive for a slight cough and increased work of breathing but was otherwise negative. Born full term via normal spontaneous vaginal delivery at 2466 g (2nd percentile), he was exclusively breastfed and immunized, with no allergies. His past medical history was significant for “episodes of wheezing,” without a formal diagnosis of asthma. A circumcision was his only surgical history. He had oral candidiasis and diaper dermatitis at 2 weeks of age, with no chronic illnesses; however, review of his electronic medical record revealed 3 hospitalizations and several ED and outpatient clinic visits.

Hospitalized twice at 4 weeks of age for projectile...

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