A premature girl with pallor and rash.

A 32-week girl was born by preterm delivery with birth weight of 1,600 g to a gravida 1 para 0 (G1P0) 26-year-old Hispanic mother. The mother’s past medical and gynecological history was unremarkable until 2 days before delivery, when she developed upper respiratory symptoms and received one dose of the second-generation cephalosporin. The infant was born by cesarean section because of abnormal fetal tracing, with Apgar of 0, 2, and 6 at 1, 5, and 10 minutes. The baby was intubated at birth and was started on intravenous ampicillin (100 mg/kg/ day); IV cefotaxime (100 mg/kg/ day); and gentamicin (5 mg/kg/day). On physical exam, the baby had severe clinical pallor and generalized erythematous rash with occasional papules and vesicles. Initial laboratory investigation showed severe neutropenia, and chest X-