RT Journal
A1 Anshelevich A, Osterhoudt KC, Introcaso CE, Treat JR
T1 PIcture of the month—quiz case
JF Archives of Pediatrics & Adolescent Medicine
JO Archives of Pediatrics & Adolescent Medicine
YR 2010
FD July 1
VO 164
IS 7
SP 673
OP 673
DO 10.1001/archpediatrics.2010.109-a
UL http://dx.doi.org/10.1001/archpediatrics.2010.109-a
AB 
A 3-week-old boy presented to the emergency department with an unusual pattern of purulent drainage and crusting overlying an area of fluctuance on the posterior scalp. The patient was delivered via emergent Cesarean section at 41 weeks' gestation to a 34-year-old woman (gravida 9, para 4) owing to fetal heart decelerations. The patient's mother reported persistent pelvic pressure for at least 12 hours prior to Cesarean section. The infant had caput succedaneum and extensive cranial molding on delivery. When discharged to home, the patient's mother noted a light brown line of scar that circumscribed the head. The posterior occipital part of this line developed an area of redness that enlarged and became crusted and fluctuant over several days. There was no fever, the patient was feeding well, and energy levels and urine output were unchanged. The patient was sent to the emergency department by his pediatrician to rule out infection due to the fluctuance of the scalp.