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New Rash and Fever in a Woman With Inflammatory Bowel Disease
Authors:
Katherine G. Garlo, MD; Nicholas Perros, MD; Robert Smith, MD; and Katy Linskey, MD
Citation:
Garlo KG, Perros N, Smith R, Linskey K. New rash and fever in a woman with inflammatory bowel disease. Consultant. 2016;56(9):823.
A 45-year-old woman was admitted to the hospital with a 5-day history of a papular-pustular rash on her face, trunk, and legs. Preceding the rash, she had had a low-grade fever, rhinorrhea, nasal congestion, nonproductive cough, and sinus tenderness.
Review of systems was positive for diffuse arthralgia, myalgia, and generalized malaise. The patient had a past medical history of Crohn disease, which had been well controlled with infliximab for more than 10 years.
At admission, her temperature was 38°C. Physical examination revealed the presence of nontender, erythematous pink papules with overlying pustules, ranging from 10 mm to 1 cm in size, diffusely scattered over her body and in varying stages of maturation (Figures). Some were newly arisen and appeared pustular. Others had erupted and were crusting over. Oral mucosal ulcers also were present.
Significant laboratory values included a white blood cell count of 17,200/µL, a C-reactive protein level of 191 mg/L, and an erythrocyte sedimentation rate of 66 mm/h. A chest radiograph showed no acute cardiopulmonary process.
Answer on next page.
Authors:
Katherine G. Garlo, MD; Nicholas Perros, MD; Robert Smith, MD; and Katy Linskey, MD
Citation:
Garlo KG, Perros N, Smith R, Linskey K. New rash and fever in a woman with inflammatory bowel disease. Consultant. 2016;56(9):823.
A 45-year-old woman was admitted to the hospital with a 5-day history of a papular-pustular rash on her face, trunk, and legs. Preceding the rash, she had had a low-grade fever, rhinorrhea, nasal congestion, nonproductive cough, and sinus tenderness.
Review of systems was positive for diffuse arthralgia, myalgia, and generalized malaise. The patient had a past medical history of Crohn disease, which had been well controlled with infliximab for more than 10 years.
At admission, her temperature was 38°C. Physical examination revealed the presence of nontender, erythematous pink papules with overlying pustules, ranging from 10 mm to 1 cm in size, diffusely scattered over her body and in varying stages of maturation (Figures). Some were newly arisen and appeared pustular. Others had erupted and were crusting over. Oral mucosal ulcers also were present.
Significant laboratory values included a white blood cell count of 17,200/µL, a C-reactive protein level of 191 mg/L, and an erythrocyte sedimentation rate of 66 mm/h. A chest radiograph showed no acute cardiopulmonary process.
Answer on next page.
