Presenter: Christian B. Anderson DO PharmD RPh, Tom Mackey DO

Dermatology Program: AZCOM/KRMC/Az Desert Dermatology

CHIEF COMPLAINT:  Unresponsive fever, irritability, adenopathy, orolabial erythema/fissures adenopathy, and distal edema.

CLINICAL HISTORY: Patient is a Caucasian male with 7day history of fever >102.5, malaise, anorexia, and irritability followed by a nonpruritic truncal eruption on day 2 then a progressively worsening conjunctival injection (mild), orolabial and nostril dryness and fissures, cervical adenopathy, and swollen/painful distal extremities. All of which proved to be unresponsive to acetaminophen, ibuprofen, amoxicillin, and azithromycin as variably dose by the patient’s primary physician during the 7 days prior to referral to our clinic.