Medical Student

This patient is a 32yo Caucasian female with no significant past medical history. She presented to our hospital with fever (102.0), tachypnea, headache, myalgia, dyspnea, peripheral neuropathy, perioral paresthesias tender posterior cervical lymphadenopathy and diffuse, flat, blanching erythematous rash (pictured). Rash had started about 5 days prior. Her 3 children (early to mid teens) also had these same symptoms. They had visited a rural emergency facility twice in that time, diagnosed with viral xanthem first, then scarlet fever and given antibiotics with continuously worsening symptoms. Respiratory viral panel negative, as well as negative strep antigen screenings. UDS negative. Children later admit to bringing home an “unknown” substance found in a friend’s basement, playing with it, vacuuming it up to clean up the mess they made. 3 hours later, the first rash appeared.