Bullous impetigo is a common cutaneous infection that primarily affects children between the ages of 2 and 5 years.1 It is caused almost exclusively by coagulase-positive Staphylococcus aureus. It is a common manifestation of a staphylococcal toxin–mediated disease. The presenting signs are typically flaccid blisters and bullae less than 3 cm in diameter.2 Without therapy these blisters and bullae may rupture, leaving superficial crusts. Although a diagnosis of bullous impetigo generally is made without difficulty, based on the observation of typical small bullae and erosions, unusual presentations may lead to confusion with other processes. We describe a patient with bullous impetigo whose physical findings resembled those of a thermal burn.
Patient Report. A 21-month-old African American presented to the pediatric emergency department at our institution with complaints of a "rash" on the buttocks, fever, and unwillingness to walk. His mother stated that he had been in the