Question-204

Patient with known Waldenström's macroglobulinemia is admitted with fever. He has a history of glandular fever infection and varicella infection in childhood. He is given ampicillin and azythromycin. The next day he develops rash.

Picture: rash is on the abdomen and chest. It doesn’t look like erythema multiforme at all. Most of the elements are raised papules, but couples of them are pustules.

What would you do to determine the cause of rash?



a. swab from the lesion
b. biopsy of the lesion
c. bone marrow biopsy
d. drug allergy test

There is not any interaction between Az+Amp
The paitent suffering WM= Hyperviscosity due to IgM
AFever is not usual presentation, although 15% of patients with WM present with fever. Meantime it is pointed out rash is on the abdomen and chest and all elements presented (papules and pustules). It seemes to me the first answer is the best answer?!
A

There is not any interaction between Az+Amp
The patient is suffering WM= Hyperviscosity due to IgM
Fever is not usual presentation of WM, although 15% of patients with WM present with fever. Meantime it is pointed out rash is on the abdomen and chest and all elements presented (papules and pustules). It seems to me the first answer is the best answer?!
A