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Rickets and gross motor delay in a child with atopic dermatitis.
Shafee Salloum1, Vishaka Hatcher2
1Department of Pediatric Hospital Medicine, Dayton Children's Hospital, Dayton, OH, USA.
Oxford Medical Case Reports
|February 22, 2021
Summary
A breastfeeding infant with atopic dermatitis developed vitamin D deficiency rickets and Staphylococcus aureus bacteremia due to a restricted diet. Early diagnosis and supplementation are crucial for preventing severe complications.
Area of Science:
- Pediatrics
- Nutritional Science
- Dermatology
Background:
- Atopic dermatitis (AD) management can involve restrictive diets due to perceived food allergies.
- Vitamin D deficiency rickets is a concern in infants with specific dietary patterns.
- Staphylococcus aureus colonization is more prevalent in patients with AD.
Observation:
- A 14-month-old boy with AD presented with hypocalcemic tetany and gross motor delay.
- Diagnosis confirmed vitamin D deficiency and rickets.
- The patient developed Staphylococcus aureus bacteremia and septic thrombophlebitis.
Findings:
- Calcium and vitamin D supplementation corrected hypocalcemia.
- Antibiotics and anticoagulation were administered for bacteremia and thrombophlebitis.
- Restricted diets in AD patients may lead to nutritional deficiencies.
Implications:
- Avoid elimination diets in AD patients; focus on skincare and appropriate nutrition.
- Maintain a high index of suspicion for rickets in children with motor delay and risk factors.
- Increased risk of infectious complications in AD patients necessitates vigilant monitoring.
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