A 75-Year-Old Woman With Fever, Rash, and Skin Pain

Thomas N. Helm, MD; Stefanos Haddad, MD; Robert E. Kalb, MD


January 30, 2017

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A 75-year-old woman with a history of hypertension, Parkinson disease, osteoporosis, and trigeminal neuralgia was admitted to the hospital for evaluation of fever, rash, and skin pain. Her widespread skin eruption started 3 days ago on her chest and spread centrifugally. She also reported a dull headache and that her eyes felt "sore and scratchy."

Her medications included hydrochlorothiazide (25 mg/d), two extended-release capsules (carbidopa [23.75 mg] and levodopa [95 mg]) three times daily, and vitamin D (800 IU daily). She had been started on carbamazepine (100 mg twice daily) for her trigeminal neuralgia 6 weeks ago; this had recently been increased to 200 mg twice daily.


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