An unusual disseminated viral primary infection: Rash, hepatitis and polyserositis

An unusual disseminated viral primary infection: Rash, hepatitis and polyserositis

An unusual disseminated viral primary infection: Rash, hepatitis and polyserositis

Case description

A previously healthy 42-year-old woman was admitted onDecember the 30th for a 9-day story of a sore throat with feverthat resisted empiric treatments including several antibiotics (cef-triaxone, cefpodoxime, coamoxiclav, metronidazole) and a shortoral corticotherapy. A maculopapular rash had appeared the 26thDecember and progressively migrated from the face and neck(Fig. 1) to the chest and limbs without affecting hands or feet.She complained also of increasing unbearable back pain anddiscomfort of the upper right quadrant beginning the day ofadmission. Physical examination identified a 40◦C fever, but nohaemodynamic, neurological or respiratory abnormalities. Throatexamination identified bilateral pultaceous tonsillitis and inflam-matory cervical adenopathies. Palpation of dorsolumbar soft tissueswas highly painful, but no meningeal sign was present. Abdom-inal and vulval examinations were normal. The patient admittedhaving oral sex contact with a partner who presented genitallesions.

read-online1

Post Comment