Case Challenge # 2

Case Challenge # 2

  • A 42 yo female is admitted with fever and LAD for 5 days. Prior history of IVDU and started on phenytoin for new onset seizures.
  • PE: Tmax 101.8, HR 115, BP 90/50. Tender cervical and axillary LAD, maculopapular rash on face and arms with periorbital edema.


  • Labs: WBC 14k (no Eos), Cr 1.0, AST 235, ALT 345. Blood Cx negative, HIV Ab negative, EBV and CMV serologies show prior exposure.

What is the best management step?

  • A) Broad spectrum abx
  • B) Prednisone
  • C) ART for acute HIV
  • D) Stop phenytoin
  • E) NSAIDs

Look forward to the answer this Friday, 2/6/15!

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