BOF 22 Jan 2016 - Screen 2 on FlowVella - Presentation Software for Mac iPad and iPhone

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QUESTION 1

A 35-year-old man presented with a rash followed by malaise and fever. The rash started on his face and spread to the trunk, extremities and genitalia over 2 days. He has no underlying illnesses.

He does not know which childhood immunizations he had.

He has no pets, no sick contacts, no travel, no promiscuous sexual activity.

Exam:

Temperature 37.8°C

Pulse 90

BP122/80

He is iIl appearing with injected conjunctiva, oral and genital ulcers, and a vesicluar rash mainly on face, back and chest (see images).

WBC is 7.5 (normal diff), routine blood work normal.

The most likely diagnosis is which of the following:

(1) Measles

(2) Disseminated HSV

(3) Chicken Pox (primary VZV)

(4) Smallpox

(5) Pemphigus vulgaris

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BOF 22 Jan 2016

By Wong Chen Seong

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