• Christina L Tupe, Bethany A Weiler, Avelino C Verceles, and Michael T McCurdy.
• Christina L. Tupe is a clinical instructor, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland. Bethany A. Weiler is a pulmonary critical care fellow and Avelino C. Verceles is an assistant professor, Division of Pulmonary, Critical Care and Sleep Medicine, University of Maryland School of Medicine. Michael T. McCurdy is an assistant professor, Department of Emergency Medicine and Critical Care, University of Maryland School of Medicine. ctupe@umem.org.
• Am. J. Crit. Care. 2016 Jul 1; 25 (4): 379-82.

AbstractA 62-year-old woman treated with several courses of corticosteroids for an undifferentiated rash came to the emergency department with progressively worsening cutaneous signs and symptoms and generalized weakness. She had scabies, and despite treatment continued to decompensate. Repeat skin biopsies revealed disseminated herpes simplex virus infection, and results of blood cultures were consistent with infection by methicillin-resistant Staphylococcus aureus. Despite antiviral and antimicrobial therapy, sepsis and multiorgan failure developed, and the patient died. This case illustrates the complications of the rare entity eczema herpeticum, which occurs most often in immunocompromised patients and is associated with a high mortality. Maintaining a high index of suspicion for this disease in decompensating patients with an unidentified rash is essential to avoid catastrophic outcomes.©2016 American Association of Critical-Care Nurses.

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