40y old male pt, symptoms of viral fever, such eruptions on 3rd day, paracetamol and cough syrup was prescribed, could it be drug related? what investigations are required?

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This is petechial rash if they are blanching... Platelet Transfusion if thrombocytopenia...ask for duration of rash..if duration is long ,it could be a case of ITP precipitated by viral fever

First Viral Exantheme.. 2nd ITP triggered by viral illness.


Porphyrias Porphyrias are a group of rare inherited blood disorders. People with these disorders do not make heme, a component of hemoglobin (protein in red blood cells that carries oxygen) properly. Heme is made of porphyrin (a naturally-occurring organic compound in the body) bound to iron. Heme helps red blood cells (RBCs) carry oxygen and also gives RBCs their color. It is also found in myoglobin, a protein in the heart and skeletal muscles. The body goes through several steps to make heme. However, in people with porphyria, the body lacks certain enzymes needed to complete this process, causing porphyrin to accumulate in tissues and blood. This may cause a variety of symptoms, ranging from mild to severe. The most common symptoms of porphyria are abdominal pain, light sensitivity (causing rashes or blisters), and problems with the muscles and nervous system. The symptoms of porphyria vary and depend on which enzyme is missing. Causes Porphyria is a genetic disease. According to The Journal of Family Planning (JFP), most types of porphyria are autosomal dominant, meaning that a person only inherits the abnormal gene from one parent. (JFP, 2012) However, certain factors may trigger symptoms, known as attacks. Factors include: drugsinfectionalcohol usecertain hormones, such as estrogensunlight Symptoms Symptoms depend upon the type of porphyria. Severe abdominal pain is present in all types, as well as urine that is reddish-brown in color. This is caused by the build-up of porphyrins, and typically occurs after an attack. Symptoms associated with hepatic disease include: limb painneuropathyhypertensiontachycardia (fast heartbeat)electrolyte imbalance Symptoms associated with erythropoietic disease include: extreme skin sensitivity to lightanemia (when the body does not produce enough new RBCs)changes in skin pigmentationerratic behavior related to sun exposure Treatment There is no cure for porphyria. Treatment focuses on managing symptoms. Most cases are treated with medication. Treatments for hepatic disease include: beta blockers (Atenolol) to manage blood pressurehigh carbohydrate diet to aid recoveryopioids for pain managementhematin to shorten attacks Treatments for erythropoietic disease include: iron supplements for anemiablood transfusionsbone marrow transplant

Nice explan Dr farooq

Get a complete blood count, bleeding time, clotting tune...possibility of itp is high

Rule out dengue fever, do CBC , give antihistamines

it is not drug allegy they produce fixed eruptions not only on limbs but on trunk also .it looks like typical rash of viral exanthem

Dear Dr, do a complete blood count, platelet count, bleeding time, clotting time.

Suspecting ITP

Petechial rash on 3rd day of illness..could b due to 1.viral exanthem..2. Evn analgesics are known to cause drug purpura..3.ITP usualy develops within weeks durig recovery from viral illness..so its also a remote posibility 4. Acute HIV syndrome can present wid al dese symptoms provided LNpathy n wt loss z present..5. Rare manifestation of acute leukemias or MDS bt in elderly.. I guess a completete blood count with good pbs review wil help clinching the diagnosis..if eosinophil counts r increased dn DRESS to b considered

drug reaction. do pletletes count.

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