Large Blisters on Baby Infant

[mikefusion]

My three week old niece was admitted to the children’s hospital with some large blisters on her hands. So far, she’s had no fever, her white blood cell count is normal, and all bacterial cultures and spinal taps have been negative. We have the pediatric staff stumped. She had a couple small blisters (pimple-size) form on her hands and feet about three days ago. Several grew to pencil-eraser size and burst. One on her index finger grew much larger and threatened to cover her entire finger. She has a few other tiny spots on her arms and legs, and several other small blisters on her feet. The blisters look like second-degree burns, mostly clear fluid inside, though some did contain a bloody mix. She’s presently on two antibiotics and an antiviral as a precaution. Anybody seen anything like this before?

Photos of her fingers are available here. The finger is coated with ointment.

http://www.hoganconsulting.com/finger1.jpg
http://www.hoganconsulting.com/finger2.jpg

[Dr. Chan Lowe]

Hello Mikefusion,

I'm sure your pediatric team is probably already thinking about the things I can think of. I suspect the antibiotics are to cover a possible infection with a bacteria such as staph or strep that produce toxins disrupting the skin and causing blisters. The antiviral is probably to cover an infection from herpes since this virus can produce blisters and can be dangerous.

If there are blisters in other places a diagnosis of epidermolysis bulllosa may be possible. In addition to your pediatric team, an infectious disease consult and a dermatology consult may be helpful if they are available.

Best wishes and I hope you are able to figure this out.