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.