Management & Follow-up
As infective causes were being considered, antibiotic coverage with
Ceftriaxone 2 gram and azithromycin 500 milligram once daily were
started on admission. It was discontinued on the third day when
preliminary blood culture reports came back negative. Steroids
(hydrocortisone IV one dose 200-milligram and then transitioned to oral
prednisolone 20 milligrams which was given for 4 days) and
antihistamines (diphenhydramine 25-milligram injection on need along
with oral fexofenadine 180 milligrams which was given daily for 5 days
then it was replaced with levocetirizine 5-milligram daily dose) and
emollient creams were given throughout the hospital stay for the
allergic symptoms. Deep Venous Thrombosis prophylaxis was provided with
enoxaparin 40-milligram subcutaneous injection daily. Oral esomeprazole
20-milligram was given for stress ulcer prophylaxis. She was discharged
on levocetirizine 5-milligram and esomeprazole 20-milligram once daily
for 5 days. She had an apparent improvement of rash after 2 days, with a
remaining mild itching and burning sensation. She was discharged home
safely on day 6 of hospitalization after all her workup was done, which
ruled out other suspected causes of her rashes.