The facial discoloration developed rapidly during the time from when he left his house to the time he arrived at the emergency room. Blood cultures were drawn and he was admitted to the intensive care unit. He was begun on imipenem-cilastatin and given fresh frozen plasma, cryoprecipitate, fluid resuscitation and dopamine. He was transferred to the University of Pittsburgh Medical Center with fever, disseminated intravascular coagulation and hypotension. College student who routinely returned home on weekends to work.
Clinical images are from a different male patient with the same diagnosis.