Parents of a two-month-old female child brought her to the emergency department (ED), with complaints of low-grade fever, congestion, nasal discharge, and “pulling at her ears”. Patient was born 33 weeks gestational age, admitted for 13 days without any intubation, with no other complain during the period of two months. During this ED visit, she was diagnosed with left otitis media and started on amoxicillin.
However, she returned to the ED two days later with multiple episodes of projectile vomiting, bloody diarrhea and decrease in oral intake, with complaints of rash developed during the previous ED visit. Physical examination: Temperature of 97.7 F Heart rate 130 breaths per minute Respiratory rate of 36 breaths per minute Skin examination revealed ecchymotic area developed on right scapula, right forearm, and bilateral inguinal folds. Laboratory findings: normal complete blood count…
