Diaper Rash

A 2-week-old baby girl presented with a rash in the diaper area. She was born prematurely at 32 weeks’ gestation and was hospitalized in the NICU.

A 4-week-old male is being seen for a 3-week history of severe diaper dermatitis. The rash has been treated with clotrimazole and a barrier cream, with some improvement about a week ago. However, three discrete, erosive lesions subsequently developed, along with a low-grade fever of 100.6°F that was documented in the ED. Due to the fever, the baby was admitted to the hospital for a sepsis workup that included a blood culture; urinalysis and urine culture; a wound culture of the larger lesion; and a herpes simplex PCR. The baby was empirically started on therapy with ampicillin plus gentamicin. A lumbar puncture was attempted but was unsuccessful, and it was later deemed unnecessary and therefore was not reattempted.