peraspera
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A 22-year-old man presents to the emergency department (ED) with what appears to be a scaly, verrucous rash involving the side of his nose (see Image 1), his left shoulder (see Image 2), the right side of his back, and the left posterior aspect of his thigh. Approximately 4 weeks prior to presentation, the patient had been treated in the ED for the same rash. At the time of the initial presentation, the review of symptoms had been negative for fevers, night sweats, and chills. During the review of the patient’s history, he stated that he had recently moved to California’s Central Valley, but he denied having any unusual exposures or medical problems and was not taking any medications at that time. Methicillin-resistant Staphylococcus aureus (MRSA) was initially diagnosed, and the patient was treated with a 10-day course of trimethoprim-sulfamethoxazole and rifampin and discharged to home.
Several weeks after the initial presentation, the patient has returned to the ED because the rash is not improving and he is now experiencing night sweats, arthralgia, and back pain.
On physical examination, he is noted to be tachycardic with a heart rate of 120 bpm; his blood pressure is measured at 100/85 mm Hg. The cardiovascular and respiratory examinations are unremarkable, but point tenderness is noted over the right clavicle, along the lower vertebral bodies, and over the anterosuperior iliac spine of the left hip. There is no abdominal tenderness. Laboratory investigations are initiated and demonstrate a normal white blood cell (WBC) count but an elevated erythrocyte sedimentation rate (ESR) at 95 mm/h. The patient is admitted to the hospital for further workup and evaluation. Consultation with an Infectious Disease specialist leads to biopsy of the lesions.
What is the diagnosis?
http://master.emedicine.com/email/image/image92/1...
http://master.emedicine.com/email/image/image92/2...
A. Actinomycosis
B. Blastomycosis
C. Coccidioidomycosis
D. Histoplasmosis
E. Erythema multiforme
F. Pityriasis Lichenoides
G. Granuloma Annulare & Pyogenic
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| new_n_lost
Politically InCorrect
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California’s Central Valley >>>C. Coccidioidomycosis
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| aaroho
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C
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| Kamsi
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C
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| hanialkhadher
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B. Blastomycosis
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| dr in trouble
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C
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| dr.wad
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I DONT KNOW
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| peraspera
Forum Elite
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Answer is:
http://master.emedicine.com/email/image/image92/i...
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| GOGETA
I'm Dr. GOGETA
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treatment is?
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| peraspera
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Treatment is:
http://www.emedicine.com/med/topic539.htm
 
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