The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case you would like to suggest for a future Case Challenge, please contact us.
A 40-day-old white male infant with a previously uncomplicated neonatal course presents with a 2-day history of expanding swelling and erythema involving the left angle of the mandible. The infant has been irritable and inconsolable for the 12 hours before presentation. His parents are very distraught. They tried feeding, rocking, and burping the infant, but nothing relieved the crying.
According to the parents, the patient had a fever on the day before admission. The infant was a 7.5-lb (3.4-kg), term baby delivered via normal, spontaneous vaginal delivery to a 26-year-old mother who was positive for group B Streptococcus (GBS) at 35 weeks gestation, rubella-immune, and negative for hepatitis B surface antigen. Rupture of the membranes occurred 10 hours before delivery, with clear fluid. The intrapartum medications included two doses of clindamycin for the positive GBS test. No perinatal maternal fever was noted. The Apgar scores were 8 and 9 at 1 and 5 minutes, respectively.
Medscape © 2015
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Faisal M Mawri, Staci Batchelder, Carrie Fales, et. al. Facial Swelling in a 40-Day-Old Boy - Medscape - Oct 28, 2015.