A 42-Year-Old Woman Comes to the Emergency Department with Fever

question 138

Multiple Choice

A 42-year-old woman comes to the emergency department with fever and a skin rash.  She was diagnosed with trigeminal neuralgia and started on carbamazepine 3 weeks ago.
The patient's temperature is 38.9 C (102 F) .  There is diffuse confluent erythema involving 60% of the body, palpable generalized lymphadenopathy, and symmetrical facial swelling.  There are no mucosal lesions.
Her aspartate aminotransferase level is 150 U/L, eosinophil count is 800/mm³, and serum creatinine is 0.9 mg/dL.
Which of the following is the most likely diagnosis?

• A)Drug-induced hypersensitivity vasculitis
• B)Drug reaction with eosinophilia and systemic symptoms
• C)Hypereosinophilic syndrome
• D)Serum sickness-like syndrome
• E)Stevens-Johnson syndrome

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