Rash and elevated creatine kinase in a deployed soldier.
A 24-year-old active duty soldier was evacuated from Afghanistan to the United States after persistent upper respiratory tract infection. His course was complicated by an exfoliative rash, diffuse muscle aches, and elevated creatine kinase following trimethoprim-sulfamethoxazole exposure that persisted despite withdrawal of the medication. Dermatomyositis was strongly considered, but the patient had a negative muscle biopsy and had positive serologies for acute Epstein-Barr virus infection. We present a case of acute Epstein-Barr virus infection and possible trimethoprim-sulfamethoxazole reaction mimicking dermatomyositis.
Department of Rheumatology, Brooke Army Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, TX 78234-6272.
Thomas W
TW
Schmidt
Department of Medicine, Brooke Army Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, TX 78234-6200.
Mark
M
Garfinkle
Department of Rheumatology, Brooke Army Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, TX 78234-6272.
Daniel F
DF
Battafarano
D055826:Afghan Campaign 2001-; D000890:Anti-Infective Agents / Q000009:adverse effects*; D003402:Creatine Kinase / Q000097:blood; D003882:Dermatomyositis / Q000175:diagnosis*; D003937:Diagnosis, Differential; D003875:Drug Eruptions / Q000175:diagnosis* / Q000209:etiology; D005076:Exanthema / Q000209:etiology; D006801:Humans; D007244:Infectious Mononucleosis / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008889:Military Personnel; D063806:Myalgia / Q000209:etiology; D010612:Pharyngitis / Q000188:drug therapy / Q000821:virology; D012206:Rhabdomyolysis / Q000175:diagnosis*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects*; D014481:United States; D055815:Young Adult
D000890:Anti-Infective Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D003402:Creatine Kinase