Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pruritus, Rash, Rash macular, Rash papular
Clinical narrative: She got her vaccine, that arm hurt real bad and went home and laid down.  On Wednesday she was out of it the entire day, cannot tell anything that happened that day.  She does not know if she was lying down a lot and that day completely slipped away from her.  She had an APT to get her car worked on, had compression socks on and could see dots through the socks on her lower mid calf on the right leg.  Since she has the venous insufficiency on her foot she thought that was it.  That night she scratched it with her foot and it was itchy and caused a skin infection and initially what she was treated for.  She was then told that her rash was spreading, and that's when it was up above her right knee, which started then showing up on her left calf.  Then it went to both knees and then between the knees and her hips, and then everywhere were regular socks were.  Also had it on her ankles, tops of her feet and between her knees and her hips.   She talked to somebody about her INR on 4/17/24, and she thought that was insufficiency on her leg.  There was an area on the right posterior that had gotten inflamed and wanting to know the difference between that and a blood clot.  She was advised to be evaluated.  Then she did not see or talk to anybody until 4/19/24, she talked to nurse triage, spoke with her cardiologist that same day, and then she went to the ER, and an office visit that same day.  At that point they told her it was an allergic reaction but did not know if it was from the vaccine or not as this was the only thing that changed.  She is on blood thinners and eats the same things day in and day out week to week.  On 4/20/24 she spoke with nurse triage and they told her to go back to UC.   Before that she did have a sore spot in her throat and was checked for strept.  They talked about the strept and then said that she had a rash, and that the spot on her foot is the venous insufficiency.  Oropharyngeal arrythmia, white spots noted on left tonsil consisted with tonsil stone.  Feet are equal and warm bilaterally, 2+ femoral pulse bilatearlly, macular rash in abdomen and lower extremities.  Rash occured on abdomen after vaccine.  Discussed care and recheck.  She was taking the Pepcid and her regular allergy pills.  Then on 4/21/24 she was in the ER and they told her to put Benadryl cream on it, and she is allergic to Benadryl and they told her that it was topical and it would be okay, which exacerbated her condition.   Her first office visit was on 4/23/24, which she was diagnosed with developing cellulitis and took her 3rd dose of Keflex and was to be rechecked in a week.  On 4/29/24 went to the ER due to the rash, and her symptoms were slightly better but not significantly improved.  She has had more swelling in the RLE more so than the left.  She had petechial lesions which form a raised papular rash on top.  These lesions were itchy and she scratched.   On 4/30/24 she was seen at her PCP's office, she had cellulitis and was told to continue the antibiotics and had a contact dermatitis due to the Benadryl cream.  The symptoms had improved with 1st course of antibiotics, she was given ADX for cellulitis.  Noted that she had improvement from the rash, they did not itchy anymore.  Then on 5/2/24 she was back in Prompt care and had wide spread rash and bruising.  Sunburn like rash on her leg, goes to stomach, left arm, 3 spots on her eyebrow, spot on her stomach after sleeping with her arm on her stomach, some look burgandy in color.  No difficulty breathing, had some dizziness.  She had labs done on her at that visit.  On 5/3/24 she saw PCP.  On 5/5/24 she was back in the UC she had neon yellow drainage coming out of the cellulitis spo.,  She had joint swelling, myalgias, notes that she has tried to rest, and the treatments provided no relief.  The patient has treated for this diffuse rash several times.  Correlation is that this rash correlates with the vaccine.  Was put on Prednisone and the sore on the back of leg has worsened with purulent yellow drainage.  She was to continue her antibiotics that she had and is to see PCP today and that they may have to change her antibiotics today.  The rash on her knees is getting better and the rashes are lighter and lighter but they are covering her abdomen and has one that is very large with darkish in color and measured it to be about 2 cm, and is spreading out so she knows it's improving.  Her skin around her stomach is also covered with that as well as her upper back.  The places were fabric is tighter on her skin the rashes are worse there.  She also has a rash on the top of her buttocks in the area of the elastic of her pants.