Case Report of COVID-19 Positive Male with Late-Onset Full Body Maculopapular Rash

Each day, novel information is being learned about Coronavirus disease 19 (COVID-19), a disease increasingly seen in the emergency department (ED). Our case adds to reports of a maculopapular rash among the newer symptoms to be aware of in diagnosing COVID-19. A 35-year-old male presented with an 11-day history of fever, dry cough, diarrhea, and change in taste. He endorsed two known exposures to COVID-19 and had previously tested negative twice for the virus. The patient additionally complained of a whole-body, pruritic rash that presented six days after his initial symptoms. A workup was completed for the patient’s fever and labs only revealed a potassium of 3.3 mEq/L. A chest X-ray showed right basilar patchy opacities consistent with pneumonia, and the patient tested positive for COVID-19 and negative for Epstein-Barr Virus, a commonly missed culprit in those with a rash, via polymerase chain reaction (PCR). The patient’s vitals were stable, and he was discharged with supportive measures at home. COVID-19 was determined as a likely etiology for the rash. With new insights into COVID-19 every day, we demonstrate a case of viral exanthema as a potential presenting manifestation in a COVID-19 patient and one that medical providers should be familiar with in these patients in the ED. TOPICS: COVID-19, dermatology, infectious disease, viral exanthema.