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Symptoms: Rash, Blistering, Malaise, Chills

Wiler, Jennifer L. MD, MBA

doi: 10.1097/01.EEM.0000296436.86381.e4
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Dr. Wiler is the assistant chief of clinical operations in the department of emergency medicine at Washington University in St. Louis.

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A 58-year-old man presents to the ED with a rash. He was seen three days prior for a “spider bite,” and was started empirically on clindamycin for suspected community acquired-MRSA.

Two days later he developed a diffuse non-puritic erythematous rash, and his internist switched him to ciprofloxacin. Overnight the patient developed skin blistering. He has had malaise and chills for two days with no fever and no mouth or eye dryness. What is your diagnosis? See p. 20.

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© 2007 Lippincott Williams & Wilkins, Inc.