A previously healthy 21-year-old Caucasian man was admitted for vasoplegic shock. He denied any drug intake, did not smoke tobacco or use illicit drugs. He presented fever (39°C) with chest tightness, non-bloody watery diarrhea lasting for 7 days and a rash that had developed for 3 days. On clinical examination, he was febrile (40°C), blood pressure was 80/40 mm Hg, respiratory rate 38/mn, and oxygen saturation 97% in ambient air. An asymptomatic rash was present over the trunk and palms, consisting of erythematous round-shapped macules with a darker and raised rim, 1-3 cm in diameter, along with bilateral conjunctivitis (Figure 1).
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