A 6-year-old boy was admitted to the hospital with generalized itching and rash for 2 days after eating fish curry which was stored in a refrigerator for a long time. Additional symptoms included fever, abdominal pain, painful and swollen hands, and swollen eyes. Symptoms improved with ibuprofen and antihistamines but continued to relapse and remit. Examination showed edematous, urticarial plaques intermixed with diffuse flushing. Neither discrete urticarial wheals nor lymphadenopathy was observed.
The conjunctivae and oral cavity were not involved. Other nonspecific symptoms include flushing, edema, tachycardia, headache, paresthesia of the mouth, abdominal pain, nausea, and diarrhea. Image source: NEJM What could be the possible diagnosis? What treatment would you recommend? *This case is from Docplexus Editorial Team for educative purpose only.
