Dangerous

A 65 year old African-American lady presents with fever, bilateral red eyes, ulcers of the lips and mouth, and a widespread erythematous rash for 2 days, which has rapidly expanded over time.

Close questioning reveals that she started self-medicating herself with Ibuprofen around 2 weeks ago, due to pain in her right knee joint while walking. Her medical history is otherwise unremarkable.

She has had a single stable sexual partner for the last 5 years. There is no history of recent foreign travel.

Select Relevant Investigations
Full Blood Count

Performed

WBC/DC: 5,000/mm3 (4,600 - 11,000)
Hb: 12.6 g/dL (11.5 - 18.5)
Hct (PCV): 34%
Platelets: 250,000/mm3 (150,000-400,000)
Skin + Mouth Swab Cultures

Performed

Culture results will be available in 3 days.
Skin Biopsy

Performed

The skin biopsy results will be available tomorrow.
Urea, Glucose, Bicarbonate

Performed

Random Blood Glucose, Blood Urea, Serum Bicarbonate: Within normal limits

Select Relevant Management
Ophthalmology Referral
Corticosteroids
IV Antibiotics
Referral to Burns Unit