This healthy 1-year-old girl developed a diffuse morbilliform rash 2 days ago following a week of upper respiratory tract infection symptoms with fever. She was seen for a health check up 2 weeks ago and received her routine immunizations. She was on day 9 of a 10 day course of amoxicillin. Yesterday she had an episode of vomiting, increasing cough, and conjunctival injection, but she was eating and drinking well and behaving normally. The amoxicillin was discontinued, and she was treated with acetominophen. The skin eruption resolved over the subsequent 3-4 days. The morbilliform eruption could have been triggered by her immunization, a viral respiratory tract infection, the amoxicillin or a combination of these factors. The differential would also include mucocutaneous lymph node symdrome.
generalized 2-4 mm red macules and papules and surrounding pallor