tonguo
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a 20 year old women with rash that begins this morning. she has been feeling feverish and anorexic during the past few days. on PE, there is a papular rash bilaterally over the chest, abdomen, and upper extremities including hands. there is no vesicle. cervical and axillary LN were palpable. her temp was 38C, WBC 9000 with normal differential. what is the most likely cause of her dz?
a. histoplasma capsulatum
b. coxiella burnetti
c. N. meningitidis
d. treponema pallidum
in my dictionary (which may not be accurate), rash is exchangeable with vascular damage, increased BV permeability and bleeding under skin, do you agree?
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| mash
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b
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| ambreen
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hi
i think you are right rash can result in underlying BV increase permeability which will result in redness of skin and some swelling but it may be with toxin producing organism
and i think underlying skin bleeds may not that much pronounced
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| mani
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agree, b
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| tonguo
Forum Senior
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i also picked b, but ....... it is wrong! the right answer is d. i still dont get it.
thanks ambreen for ur explanation!
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| tonguo
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forgot to mention this: i think the answer in the book is wrong, agree?
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| mash
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no tongou, its right... rash is rare in Q fever..
sec syphilis presents as MP rash on palms and soles/skin/MM with constitutional symptoms of fever malaise/ anorexia/ gen LAP/myalgia
its D
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| polkos
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i agree with mash...remeber coxiella infections doesn't cause rash
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| bluedusk
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yeah, i came down to neisseria septicemia and syphilis on this and thought it was syphilis because of the normal differential, b/c a septicemia would have bumped the whites....
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| mani
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bluedusk, meningococcemia would be that mild an illness. Pt will be muck more "sick". i agree its d as rash isnt common in q fever
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| bluedusk
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yeah, good point!
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| bactitech
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I think the big clue here is the rash on the hands. I seem to remember this on my MT registry years ago. Most infections don't produce a hand rash.
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