PMC8077672_01
images of rashes on presentation and after treatment. Before: A) maculopapular, erythematous rash over palmar surface hand; B) papular rash over torso; C) desquamating rash over eyelids; D) mucositis of lips; after: E) resolution of rash over palms; F) torso; G) eyelids; H) lips
PAMJ-38-174-g001.jpg
PMC8077672_01_PAMJ-38-174-g001.jpg
F1
The rash was non-tender, with erythematous desquamating lesions over the eyelids and bilateral conjunctivitis (Figure 1).
graph comparing changes in ejection fraction with temperature. Elevated Temperature shown to settle with methylprednisolone (MP) and intravenous immunoglobulin (IVIG)
PAMJ-38-174-g002.jpg
PMC8077672_01_PAMJ-38-174-g002.jpg
F2
A transient resolution of the fever coincided with steroid initiation, and a subsequent elevation in temperature was noted when the steroids were interrupted (Figure 2). On day four of admission, in light of an audible gallop rhythm, persistently low mean arterial pressures and newly elevated cardiac troponin-T levels, a repeat ECHO was performed, revealing an ejection fraction (EF) of 10% (Figure 2) with global hypokinesia, four chamber dilation, moderate functional tricuspid and mitral regurgitation with a sliver of pericardial effusion. Defervescence was noted on day six (Figure 2), accompanied by a downward trend in inflammatory markers, LDH and ferritin.