How to deal with recurrent fever and papules in a 3-month-old baby despite taking medicines?

Question

Hi doctor,

We have three months baby in our family suffering from health issues for about 15 days. We spent 15 days in the village and then came back to the city after that all happened.

1) For one week the baby had a fever and all over body papules.

2) For another six days with no fever then we consulted a pediatrician and dermatologist and they gave syrup Cefpodoxime Proxetil 1.5 ml BD for five days and ointment Ceflox CF on bigger nodular bumps and Dermocalm lotion for severe itching. 80 percent of things were fine.

And suddenly new papules emerged and redness under the eye and small acne on the cheeks appeared. So the doctor added Omnacortil 0.5 ml BD for two days then 0.5 ml OD for two days, Neosporin ointment under the eye area, and Himalaya antiseptic cream. Again high fever has started and black nodules turn into red and new nodules are coming at new sites. Please advise what it is and what to do further, is the treatment going on correctly?

Answer 1

Hi,

Welcome to icliniq.com.

I have gone through your case.

Well in my opinion this is a little bit complicated case for online opinion. There is a number of possibilities the child is suffering from.

The first one is viral exanthem. As you told that high grade fever followed by papular eruption on the whole body. This shows viral eruption.

Secondly, as you told new papules are erupting, so it could be due to a drug reaction like the child has been given multiple antibiotics which can lead to its eruption.

Acne-like lesions are not uncommon in children of this age and could be due to maternal hormones.

Now in the picture (attachment removed to protect the patient's identity) the rash, in my opinion, looks to be in the resolving phase. However, the nodules which you are talking about are remnants of the rash and require a topical antibiotic as it looks to be filled with pus.

All management given so far is fine and the child should be given well-supportive treatment including fluid and electrolyte balance.

So drug rash and viral exanthem are my two possibilities.

But need complete evaluation and examination.