Reference no: EM133790792

Question

At birth, Ricardo seemed to be a normal healthy baby. He gained weight normally and cried vigorously. Soon after birth, however, his mother noticed that he had 10 loose bowel movements a day. On the 17th day after birth, he developed a rash on his legs, which over the next 7 days spread over his entire body. His parents brought him to the emergency room at Children's Hospital, and also reported that he had had a dry cough for the past week. On physical examination, Ricardo's weight, length, and head circumference were normal. The diffuse papular scaly rash was worst on his face but also covered his trunk and extremities. Small blisters were present on his palms and the soles of his feet, which were red. He had purulent conjunctivitis (yellow discharge from his eyes), his eardrums were normal, and his heart and lungs were normal. The liver and spleen were not enlarged. Ricardo's parents had three normal children, but had had two other children, a boy and a girl, who had died soon after the onset of a similar rash at 1 month old. The parents were first cousins of Portuguese extraction. Ricardo was admitted to the hospital. Blood.