Age: 32.0
Sex: M
Vaccine: COVID19
Symptoms: Dysphagia, Erythema, General physical health deterioration, Impaired work ability, Odynophagia
Clinical narrative: Mar 8, 2022:   Ate a cookie that had walnuts in it around 12PM Tuesday. By 2PM, I started getting hives on my forearms. I thought it was a normal reaction I would have to eating a walnut, and didn't think it was serious. I took one Claritin when I got home around 6PM since I still had hives. By 10PM, the hives continued to spread and I took one dose of Benadryl before bed.   March 9, 2022:  Woke up with hives all over my body. I took another Benadryl, called off of work, and went to urgent care around 10AM. At urgent care, I was prescribed 50mg of Prednisone and to continue taking Benadryl every 6 hours. By 10PM at night, the hives continued to spread and was not getting better. My skin started to swell as the hives would last for the entirety of the day. At 10PM, I spoke with a doctor through Teladoc since my condition continued to worsen. I was prescribed Xyzal, an Epipen, and more Prednisone. Since it was late, I couldn't pick up any new medication.   March 10, 2022:  I scheduled an appointment with Dr. from ENT and Allergy. He recommend to continue the predinsone, and take a Zyrtec (Cetirizine 10 mg) once every 4-6 hours. My hives and swelling continued to persist through the day.  March 11, 2022:  I continue the medication and the hives still don't go away. By 6:30PM, my head begins to see some swelling. At 12:30AM, I start to feel my throat start to swell and close up. My throat would hurt while I drink water and try to swallow. At that point, I administered the Epipen into my thigh and called emergency. I was picked up by an ambulance and brought to Medical Center. At 2PM I was given Benadryl, Solumedrol, and fomatadine through an IV. Within 10 minutes, my hives began to go away. At 9AM, before checking out of the ER my hives started to reappear. I was administered another dose of Benadryl prior to being discharged.   March 12, 2022:   After being discharged, I called ENT and Allergy at 10AM to speak with my allergist. I was connected to the off-hours doctor and spoke with Dr. She stated she's been seeing multiple cases like mine due to the Moderna booster, and advised my current medication doses were not enough. I was advised to take: - 2 doses of zyrtec (20 mg cetirizine) every 4-6 hours -50 mg of prednisone once a day, morning - 50 mg of Hydroxyzine once a day before bed  With this medication dose, my hives were contained throughout the day and next  March 16, 2022:  I continued to take off work since the amount of medication would keep me drowsy throughout the day. I had a followup with Dr. this day, and she switched my medication routine to the following:  - 50 mg of Prednisone once a day - 1 Allegra & 1 Zyrtec - every 4-6 hours - Fomatadine 20mg - twice a day - 10 mg Montelukast - once before bed - 50 mg Doxepin - once before bed  This medication was able to contain my hives throughout the day. I would get hives or red marks on my body every 4-6 hours and would trigger me to take a dose of zyryec & allegra.   March 27, 2022:  Im continuing to take medication daily, but my doses are continuing to taper down. I still get red marks on my body, but taking an allegra will help minimize them through the day.