Facial Swelling in a 40-Day-Old Boy

Faisal M. Mawri, MD; Staci Batchelder; Carrie Fales; Ranjini Srinivasan; Walid Abuhammour, MD


October 28, 2015

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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.


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