Diffuse skin rash, altered mental status · Dx?

A 74-YEAR-OLD CAUCASIAN MAN presented to the hospital with intractable back and chest pain, a diffuse skin rash, and altered mental status. He said that 2 days ago, he'd gone to a different local hospital for treatment of back pain and a headache that had begun 3 days earlier. He was treated wi...

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Bibliographic Details
Published inThe Journal of family practice Vol. 66; no. 11; p. E7
Main Authors Reed, Caitlyn T, Cruse, Allison R, Jackson, Jeremy D
Format Journal Article
LanguageEnglish
Published United States 01.11.2017
Subjects
Aged
Diagnosis, Differential
DNA, Viral - analysis
Exanthema - complications
Exanthema - diagnosis
Herpes Zoster - complications
Herpes Zoster - diagnosis
Herpesvirus 3, Human - genetics
Humans
Male
Mental Disorders - diagnosis
Mental Disorders - etiology
Polymerase Chain Reaction
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Summary:A 74-YEAR-OLD CAUCASIAN MAN presented to the hospital with intractable back and chest pain, a diffuse skin rash, and altered mental status. He said that 2 days ago, he'd gone to a different local hospital for treatment of back pain and a headache that had begun 3 days earlier. He was treated with intravenous hydromorphone and sent home with a prescription for meperidine. He said that several hours after being treated with the hydromorphone, the rash developed on his head and then spread to his trunk and upper extremities. WHAT IS YOUR DIAGNOSIS? HOW WOULD YOU TREAT THIS PATIENT?
ISSN:1533-7294