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Picture of the Month Quiz

A girl carried to term and born weighing 2.87 kg was delivered spontaneously to a 29-year-old woman with no medical illness. She had meconium aspiration at delivery and was ventilated for 2 days. Her stay in the ward was complicated by the development of pneumothorax and recurrent hypoglycemia. On day 4 she developed thrombocytopenia (platelet count, 88 000/mL). Three days later, she was noted to have an erythematous patch at her back that was treated as cellulitis with intravenous antibiotics. However, the lesion persisted and dermatologic review on day 9 of her life revealed an indurated, well-defined, purplish plaque measuring 10.5 x 8 cm over her back (Figure) that was tender and warm but nonpulsatile. The remaining findings of her physical examination were normal.

Image of a girl carried to term and born weighing 2.87 kg at birth

Figure.

What is your diagnosis?

For a complete discussion read the Picture of the Month—Quiz Case.