Days 3-4: Continuation of Care
Infectious disease and the hospitalist group continue to oversee the
patient’s care in collaboration. His echocardiogram reveals no abnormal
findings. The patient is discontinued from vancomycin due to continued
eosinophilia. Furthermore, three serial blood cultures all have negative
findings, and infectious disease recommends the patient discontinue
cefepime. Punch biopsy results are finalized revealing fibrinoid
necrosis with a leukocytic and neutrophilic infiltrate. The pathologist
reports a high suspicion for IgAV but recommends clinical correlation.
Methylprednisolone is prescribed.