Seven-Month-Old Jerusalem Infant Developed Rapidly Spreading Rash, Doctors Said It Was Likely Viral Hives

Tehila, a 7-month-old girl from Jerusalem, developed red spots after waking from a nap, and the rash quickly spread across almost her entire body. Her mother, Mirav, said she first thought the problem might be from grass Tehila had played on earlier or from fruit she had eaten, but the rash kept worsening. The family first went to their health fund clinic, then to an urgent care center, and finally to the emergency room after the rash returned and expanded again.

At the clinic, Tehila received an antihistamine and was told to seek care if her condition worsened. At the urgent care center, a doctor gave her a steroid injection. By the next morning the rash had almost disappeared, but it came back gradually during the day. On Wednesday morning it covered nearly her whole body, and Mirav said, “It was very frightening,” prompting the trip to the ER.

Dr. David Rechtman, head of the pediatric emergency department at Hadassah Mount Scopus Hospital, said Tehila was diagnosed with viral urticaria, a common childhood rash. “I fully understand the parents’ alarm,” he said, noting that emergency departments see children with urticaria almost every day because it looks dramatic. He added that the condition can come and go in waves for weeks and usually does not require special treatment, though antihistamine drops can help with itching.

Rechtman said parents often assume a rash is an allergy, but in children, “in 90% of cases” it is caused by a viral illness. He said most children arrive to the hospital “happy and calm,” while the parents are the ones in distress. He warned that a child who is agitated, lethargic, or short of breath may be having a severe allergic reaction. He also advised pressing on the rash to check whether it disappears briefly, which would rule out petechiae, small skin bleeds that can signal an invasive bacterial infection. If the child looks well and the rash fades under pressure, blood and urine tests are usually unnecessary, he said; further evaluation is needed if the child looks pale, lethargic, short of breath, or has a fever.