title: A 3-Day-Old Girl Referred From Her Pediatrician for Oral Ulcerations.
abstract: A 3-day-old girl was referred from her pediatrician for oral ulcerations. The patient was otherwise well appearing and afebrile. Her prenatal and antenatal courses were unremarkable, except for a failed routine hearing screen. The patient's examination was notable for several yellowish ulcers on erythematous bases located on her anterior tonsillar pillars. The patient also had a right coloboma and a II/VI systolic ejection murmur. Laboratory analyses revealed a traumatic lumbar puncture with 182 000 red blood cells and 808 white blood cells, as well as a complete blood count that showed thrombocytopenia and leukocytosis. During the patient's hospitalization, she developed a new facial rash. Her physical examination findings, along with her diagnostic evaluation and hospital course, ultimately led to 2 surprising diagnoses elaborated on in this case discussion.
authors: Children's National Medical Center, Washington, District of Columbia mary.lauren.m.neel@vanderbilt.edu.
authors: Mary Lauren
authors: ML
authors: Neel
authors: Children's National Medical Center, Washington, District of Columbia mary.lauren.m.neel@vanderbilt.edu.
authors: Jeremy
authors: J
authors: Kern
authors: Children's National Medical Center, Washington, District of Columbia.
authors: Tova
authors: T
authors: Ronis
mesh_terms: D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000151:congenital* / Q000175:diagnosis; D009634:Noonan Syndrome / Q000150:complications / Q000175:diagnosis*; D019226:Oral Ulcer / Q000209:etiology*; D010372:Pediatrics; D012017:Referral and Consultation