Male Infant With Rapidly Progressive Skin Lesions

A 7-month-old male infant presented with fever for 2 days and rash for 1 day. The patient had received a diagnosis of croup 1 week before admission. Physical examination revealed hypotension and purpuric lesions with surrounding erythema over the right thigh and buttock (Figure 1). Laboratory testing revealed anemia, neutropenia, and hyponatremia. The buttock lesion evolved into a gangrenous eschar with a central dusky necrosis, followed by a surrounding halo 12 hours later (Figure 2).

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