A 10 day old neonatal girl presents with parents with concern for a rash along her scalp. Over the past two days the rash has been spreading along her scalp.
The child is otherwise eating well, sleeping well, and has had no fevers or cold symptoms. The parents state that the baby had a small scratch from a scalp monitor at birth, near the site of the rash.
Image by permission of James H Brien, DO
What is the next step in management?
- Recommend that the parents apply olive oil to the scalp of the baby to help moisturize the rash and to use a fine-toothed comb to break up the scales
- Obtain IV access and perform a full neonatal septic work-up, including blood cultures, urine cultures and cerebrospinal fluid cultures and start the infant on IV antibiotics.
- Perform a skin biopsy of one of the lesions, looking for eosinophilia and follow up on the results with the primary care doctor.
- Prescribe a course of topical mupirocin to the site and follow up with the primary doctor in one week.
This question appears in Med-Challenger Pediatric Emergency Medicine Exam Review with CME - 3rd Edition
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