0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Special Feature |

Picture of the Month—Quiz Case FREE

Jennifer L. Goldman, MD; Amy J. Nopper, MD; Angela L. Myers, MD
[+] Author Affiliations

Author Affiliations: Department of Pediatrics, School of Medicine, University of Missouri–Kansas City (Drs Goldman, Nopper, and Myers), and Sections of Infectious Diseases (Drs Goldman and Myers) and Dermatology (Dr Nopper), Children's Mercy Hospital and Clinics, Kansas City.


SECTION EDITOR: SAMIR S. SHAH, MD, MSCE


Arch Pediatr Adolesc Med. 2012;166(2):185. doi:10.1001/archpediatrics.2011.762a.
Text Size: A A A
Published online

A 17-year-old girl with a history of chronic feeding intolerance secondary to gastroparesis was admitted for gastrojejunostomy tube placement. She developed soreness at the site of gastrojejunostomy placement, and the soreness was managed with analgesics and frequent application of warm packs to the area. Six days following tube placement, she developed a lacy, erythematous eruption on the right side of her abdomen. Treatment was initiated with intravenous cefazolin sodium and later broadened to piperacillin sodium and tazobactam sodium due to concerns of worsening cellulitis. Cultures of the area were not obtained. Initial laboratory findings including those of a complete blood cell count were unremarkable, and the C-reactive protein level was minimally elevated at 22 mg/L (to convert to nanomoles per liter, multiply by 9.524). She did not have fever, chills, or other systemic symptoms. The skin findings worsened despite broad-spectrum intravenous antimicrobial therapy. Skin examination revealed a several-centimeter, macular, brightly erythematous, reticulated patch on the right side of the abdomen (Figure). There was minimal ill-defined edema in the area of the eruption, and the rash was slightly tender to palpation. The area was not warm to touch.

Place holder to copy figure label and caption
Graphic Jump Location

Figure. Abdominal skin findings on a 17-year-old girl following gastrojejunostomy tube placement.

Figures

Place holder to copy figure label and caption
Graphic Jump Location

Figure. Abdominal skin findings on a 17-year-old girl following gastrojejunostomy tube placement.

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections