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Diffuse skin rash, altered mental status · Dx?

Caitlyn T Reed1, Allison R Cruse1, Jeremy D Jackson1

  • 1University of Mississippi Medical Center, Department of Dermatology, Jackson, MS, USA.

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Summary
This summary is machine-generated.

A 74-year-old man developed a diffuse rash and altered mental status after receiving intravenous hydromorphone for pain. This case highlights potential adverse drug reactions and the importance of differential diagnosis in emergency medicine.

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Area of Science:

  • Internal Medicine
  • Emergency Medicine
  • Toxicology

Background:

  • A 74-year-old male presented with severe back and chest pain, a widespread skin rash, and confusion.
  • The patient had recently sought treatment for headache and back pain at another hospital.

Observation:

  • The patient received intravenous hydromorphone and was prescribed meperidine.
  • A diffuse rash appeared on his head hours after hydromorphone administration, subsequently spreading to his trunk and upper extremities.

Findings:

  • The clinical presentation suggests a potential adverse drug reaction or hypersensitivity.
  • Differential diagnoses include drug-induced rash, toxic epidermal necrolysis, and other systemic inflammatory conditions.

Implications:

  • Prompt recognition and management of adverse drug events are crucial in patient care.
  • This case underscores the need for thorough patient history and medication reconciliation in emergency settings.