A 22-year-old woman presents to the Emergency Department with fever, chills, headache, muscle aches, and a diffuse erythematous rash resembling sunburn over her body. Her symptoms have developed over the past 48 hours. Of note, she had an insect bite on her left calf 5 days ago that caused some local cellulitis. She has no significant past medical history or recent travel history.
On physical examination, she has a temperature of 39.5°C, pulse rate of 138 bpm, BP 96/60 mmHg with a respiratory rate of 36 breaths/minute. She is mildly confused and agitated with a GCS of 14/15. Her left calf has a 7x5cm patch of erythema, tenderness and swelling with normal joint movements above and below. The rest of the examination is non-contributory.
Written by Dr Elaine Yip
First published 22 September 2022