Background: Rash and Diarrhea are common manifestations of food allergy in Neonates.
Objectives: To present a case with an unusual diagnosis
Case presentation: A 4 w/o boy was admitted due to watery diarrhea after each feeding that started 2 days previously. A week before his admission an erythematous rash on his trunk was noted. His appetite was intact there was no fever or other accompanying symptoms. Perinatal history was unremarkable. BW was 2725g. He underwent circumcision at 8 days and was eating cow milk based formula 90ml every 3-4 hours. Family history was unremarkable; parents were of Yemini and Persian decent and he had 6 healthy siblings. Physical exam reviled a maculopapular rash with target lesions-resembling erythema multiforme, heart and lung examination was normal. CBC, blood chemistry, CRP, ESR and urinalysis were normal. Stool cultures and virology tests were negative as were VDRL, TPHA, CMV, EBV, Mycoplasma, and herpes serology. Skin test for milk was negative. Under a presumptive diagnosis of non IgE mediated milk allergy he was switched to extensively hydrolyzed formula and then to amino acid based formula and after 10 days the diarrhea improved and resolved and upon discharged the rash had also significantly subsided. A few days later the rash reappeared.
Conclusions: What is your diagnosis?
