Case 34-2005 -- A 10-Year-Old Girl with a Bullous Skin Eruption and Acute Respiratory Failure

doi:10.1056/NEJMcpc059029

Volume 353:2057-2066		November 10, 2005		Number 19

Case 34-2005 — A 10-Year-Old Girl with a Bullous Skin Eruption and Acute Respiratory Failure

Robert L. Sheridan, M.D., Vincent Liu, M.D., and Sudha Anupindi, M.D.

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Presentation of Case

A 10-year-old girl was transferred to the Shriners Hospitalfor Children because of a bullous skin eruption, with sloughingof the skin and respiratory failure.

The patient had been well until two months before admission,when she had a generalized tonic–clonic seizure. She wasexamined at another hospital and treated with diazepam. An electroencephalogramobtained the next day revealed no abnormalities. A neurologistbelieved that the risk of a recurrent seizure was low, and therefore,no antiseizure medication was prescribed. Two weeks later, magneticresonance imaging (MRI) of the brain showed a cyst, 7 mm indiameter, in the left . . . [Full Text of this Article]

Differential Diagnosis

Dr. Vincent Liu's Diagnosis

Pathological Discussion

Discussion of Management

Management of the Wound

Management of Multiple-Organ Failure

Survival and Long-Term Outcome

Final Diagnosis

Source Information

From the Burn Surgical Service, Shriners Hospital for Children (R.L.S.); the Division of Burns, Department of Surgery (R.L.S.), and the Departments of Pathology (V.L.) and Radiology (S.A.), Massachusetts General Hospital; and the Departments of Surgery (R.L.S.), Pathology (V.L.), and Radiology (S.A.), Harvard Medical School — all in Boston.