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Herpes Simplex Virus Type 2 Infection and Acute Urticaria

Herpes Simplex Virus Type 2 Infection and Acute Urticaria

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Case 1:

A 37-year-old woman complains of "itchy bumps" that erupted just above her
waist 2 or 3 days earlier. She denies having had this condition in the past.
The patient is otherwise healthy and takes no medications. An avid gardener,
she claims to be able to identify and avoid poisonous plants.

What condition is responsible for these lesions?

A. An acute contact dermatitis to something in the garden.
B. An acute contact dermatitis to something other than plant material.
C. Herpes simplex.
D. Herpes zoster.
E. Impetigo.

Your initial approach includes which of the following?

F. Perform a bacterial culture.
G. Perform a viral culture.
H. Postpone antibiotic therapy pending culture results.
I. Prescribe a potent topical corticosteroid.
J. Prescribe a systemic corticosteroid.

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Figure 1
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Figure 2

Case 2:

A pruritic eruption developed on the trunk and extremities of a 9-year-old
girl 1 day after she started taking amoxicillin/clavulanate. The antibiotic had
been prescribed for a sinus infection of 2 days' duration.

Which course of action do you pursue?

A. Change the antibiotic to an erythromycin-based agent, and prescribe an
antihistamine.
B. Continue the amoxicillin/clavulanate, and add an antihistamine.
C. Continue the amoxicillin/clavulanate, and add a systemic corticosteroid.
D. Discontinue the amoxicillin/clavulanate, and prescribe an antifungal antibiotic.
E. Continue the current regimen.

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