Olivia Knott, MD, received the First Place Award for Outstanding Presentation at the 2018 Annual Meeting of the Association of Medicine and Psychiatry’s Clinical Case Vignette Competition in Chicago. Dr. Knott presented her case titled “Relatively Rare Drug Related Skin Rashes” against 7 other finalists out of the many abstracts submitted. She described the case:
“The clinical vignette was about a 24-year-old man who developed a diffuse rash, hypotension, and shortness of breath 1 day after taking ciprofloxacin for fever and sore throat. There was originally confusion regarding his diagnosis; toxic epidermal necrolysis (TEN) vs drug reaction with eosinophilia and systemic symptoms (DRESS) as his rash looked like it could be either TEN or DRESS. His labs looked more like DRESS, but cipro is not known to cause DRESS. Upon gathering further collateral information, we found that he was started on carbamazepine 4 weeks prior to presentation. Likely it was the carbamazepine that caused his symptoms rather than the cipro, however the interaction between cipro and carbamazepine acutely increased serum levels of carbamazepine, which exacerbated his presentation. With this we were able to more definitively diagnose him with DRESS.”
Dr. Knott is completing her final year in the Internal Medicine-Psychiatry Residency program. She is grateful to Drs. Vicki Kijewski and Jess Fiedorowicz for their mentorship.