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A forty-four-year-old Caucasian male experienced a sore throat and fever two weeks before his presentation. A throat culture at an urgent care clinic showed group C streptococcus, and he received five days of amoxicillin. Three days after completing the amoxicillin, his sore throat returned, and he was then given Augmentin for ten days. Several days into the Augmentin, he developed a pruritic rash on his buttock, spreading to his arms and legs. He was instructed to stop the antibiotics and take diphenhydramine for a possible drug reaction at urgent care. He then traveled to S. Carolina for work.


There, he developed a worsening rash, pain in his fingers, wrist, and feet, and a temperature of 100.8 F. He was admitted to a hospital with a WBC count of 21,000 (no eosinophilia), an ESR of 26, and a CRP of 242. His echocardiogram was normal.


Possible Diagnoses: