27yr F has come yesterday with c/o body pain headache and throat irrtation and fever with shivering and mild cough she had 2or3 vomiting before that . o/e she is febrile temp 101 f pulse 100/bpm bp 100/70 no dehydration .in my area as earlier i have notified it is endamic with swine flue ie h1n1. so she was given paracetamol650mg tds and Azithromycin 500mg od . today morning she has not taken any medication but noted rashes as in picture predominently on face no burning no itching etc o/e rashes are discreet and all over mainly face on hard palate and soft palate also suspicious for kopliks spot. so confusion is .are these rashes of d/d 1 swine flu 2 G measales 3 dengue fever or 4 drug induced . can you help me in dx



Drug induced

Investigate her

It looks like drug induced

Go with investigation cbc, MP, widal, dengue, these rashes are urticaria type

The rashes may be drug induced but patient may have dengue so go lgM ab test

If we r suspecting h1n1 better to go throat swab for h1n1...and start tab tamiflu 75mg bd for 5days

What is her Platelets count & TLC /DLC report


Drug induced

Dengue check

This seems to be viral infection Only symptomatic treatment needed Don't use antibiotics

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