CASE HISTORY: First Presentation
He presented to our ED on day 7 of illness with fever, malaise, body
aches, and pain and swelling behind the left popliteal fossa. His heart
rate was 96, blood pressure of 135/76, temperature of 99.5F and an O2
saturation of 96% on room air. The differential at the visit included
cellulitis, COVID-19, tick-borne illnesses, and viral respiratory
infection. A COVID-19 PCR test was ordered and resulted negative during
his ED stay. The rash had evolved into an erythematous rash with a
necrotic-appearing center and crust (Figure 1), consistent with a
potential variant of EM.6