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A five-day-old girl was admitted to the hospital because of a worsening rash from birth and leukocytosis with blasts.
The infant was delivered at 40 weeks' gestation by a 24-year-old woman (gravida 2, para 2), who had immigrated from Central America to the United States two months earlier. The pregnancy had been complicated by a urinary tract infection and by a vaginal discharge, which had been treated with topical medication.
The mother had no history of oral or genital herpes, sexually transmitted diseases, or varicella during the pregnancy. Ultrasonographic examinations of the fetus, reportedly performed at four and seven months'
Differential Diagnosis
Infection as the Primary Problem
Bacterial Infection
Herpetic Infection
Leukemoid Reaction versus Congenital Leukemia
Transient Myeloproliferative Disorder
Clinical Diagnosis
Dr. Lawrence C. Wolfe's Diagnosis
Pathological Discussion
Anatomical Diagnosis
Addendum
Source Information
From the Division of Pediatric Hematology/Oncology, Floating Children's Cancer Center at Tufts New England Medical Center, and the Department of Pediatrics, Tufts University School of Medicine (L.C.W.); the Division of Pediatric Hematology and Oncology, Massachusetts General Hospital for Children (H.J.W.); the Department of Pathology, Massachusetts General Hospital (J.A.F.); and the Departments of Pediatrics (H.J.W.) and Pathology (J.A.F.), Harvard Medical School — all in Boston.
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