Scabetic Lesion

Figure 2.147. CT scan of the same infant several days later with congenital toxoplasmosis. Note the rapid progress with massive loss of brain parenchyma and multiple scattered areas of calcification. Peripheral white blood count was remarkable for 96% eosinophils. There were numerous eosinophils in the cerebrospinal fluid. In toxoplasmosis, anemia, thrombocytopenia, and at times severe leukopenia may be present. The cerebrospinal fluid is xanthochromic, has an elevated protein level, and may contain erythrocytes and leukocytes.

Figure 2.148. Pathologic specimen showing a section of the brain from the same infant as in Figure 2.147. Note the hydrocephalus and cortical necrosis present at autopsy.

Figure 2.148. Pathologic specimen showing a section of the brain from the same infant as in Figure 2.147. Note the hydrocephalus and cortical necrosis present at autopsy.

Figure 2.149. This infant has neonatal tinea capitis (ringworm), which was diagnosed at the age of 3 weeks. The condition is rarely seen in the neonate. Lesions are sharply outlined and ring- or disc-shaped, and there may be confluent areas of alopecia with areas of broken and brittle hair observed on an erythematous, scaling scalp (silvery scales). The diagnosis of ringworm of the scalp can frequently be made by the presence of fluorescence under a Wood's light (the affected scalp appears green due to fluorescence of the infected hairs) or by microscopic examination of infected hairs. In the neonate, the infection is usually produced by Microsporon canis, M. audouinii, or Trichophyton tonsurans. The hair does not fluoresce in a Trychophyton tonsurans infection. (Levy, M., Moise, K.)

Trichophyton Tonsurans Infection

Figure 2.150. This infant presented with scabies at the age of 17 days. The mother had scabies. This parasitic infection is uncommon in the neonate. The distribution of the lesions is different from that of the older child in that the face, head, and neck may be involved, especially if the mother is breastfeeding. There may be scabetic burrows, papules, and vesicular lesions. In addition there is involvement of the usual areas such as the flexor surfaces of the extremities, the interdigital spaces, the groins and the axilla.

Figure 2.151. A close-up of die hand in die same infant as in Figure 2.150 showing the typical scabetic lesions. Primary lesions are burrows, papules, and vesicular lesions. Secondary bacterial infection causing pustules may occur.

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