Development of a Rash After Hot Tub Use.

Previously published Photo Quizzes are now featured in a mobile app. Get more information at http:// www.aafp.org/afp/apps. A man presented with a rash that appeared one to two days after he used a hot tub. He developed chills and a fever of 102°F (39°C) the day after the rash appeared. The rash continued to spread and the fever persisted even though he had been taking oral trimethoprim/sulfamethoxazole for two days. Physical examination revealed four or five superficial, tender, isolated, painful, erythematous nodules in bilateral axilla that were f luctuant and 0.5 to 1 cm in size (Figure 1). Incision and drainage produced a small amount of thick, purulent exudate from each nodule. The erythematous nodules on his abdomen were 1 to 3 mm in size and were not fluctuant. There was a pustule with surrounding erythema on his right calf.