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A 2 year old with a rash

Department of Neonatology, Leicester General Hospital, Leicester, UK

Correspondence to:
Correspondence to:
Dr A Elias-Jones
Department of Neonatology, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK; Alun.elias-jones@uhl-tr.nhs.uk

Submitted 2 November 2005
Accepted 23 December 2005

The first 150 words of the full text of this article appear below.

A 2 year old developmentally normal boy presented to the paediatric admissions unit, with a three day history of a rash. The rash was over his right shoulder, arm, and back. He was systemically well, and had had chickenpox twice previously. On examination he was well, there were red, raised, crusty vesicles on his right chest wall, back and upper arm, as illustrated in figure 1.

View larger version (83K): [in this window] [in a new window]   Figure 1  The picture shows a child with a vesicular rash on right upper body, consistent with herpes zoster.

Answer
The rash was diagnosed as herpes zoster, he was prescribed a 10 day course of oral aciclovir and discharged home.

Two days later he represented to the paediatric admissions unit. He was unwell, with a one day history of high fever, vomiting, and lethargy.

On examination he was feverish at 40°C, poorly perfused, capillary refill time . . . [Full text of this article]