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Ch 18

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Los Angeles Mission College
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(Q001) Scenario
Jackson is a baby whose mom, Sandy, notices that he seems to have diaper rash very
One morning while changing him, Sandy sees that his buttocks seem particularly red
and that small, bubbly blisters seem to be forming. When she cleaned him up, he was
noticeably in pain from it, even though she tried hard to be gentle on his skin.
Being a new mom, she decided to have Jackson's pediatrician look at the rash, and she
made an appointment for the next day.
Signs and Symptoms
On the morning of the appointment, Jackson was very fussy, and when Sandy checked
his diaper, she saw that the blisters had spread and now appeared crusty, while the
redness was moving down his legs and across his scrotum. She gently tried to clean
him up, and when she rubbed with the wipe lightly, his skin sloughed off too. Now
panicked, she loaded him into the car and raced to the pediatrician.
The doctor looked at the rash, and also noted that Jackson had a fever. She ordered
blood and fecal cultures and sent him to the hospital.
Blood cultures and cultures of affected skin were negative for growth. But a swab of a
nasal abscess noticed on physical exam was positive for growth overnight. The
microbiology technologist prepared subcultures on new media, including a blood agar
plate and a mannitol salt agar plate. Colonies grew on both types of media overnight.

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