A 32-year-old man with a history of travel to the rainforests of Salto Ángel, Venezuela, presented 6 months after his travel with skin lesions on the nose and neck of 3 months’ duration. He was seen by 2 dermatologists, a family physician, and an otolaryngologist in Venezuela as well as 2 dermatologists, 2 family physicians, a nurse practitioner, and an infectious diseases specialist in the United States. These 10 clinicians collectively prescribed oral amoxicillin, cefadroxil, cephalexin, azithromycin, clindamycin, and cefdinir as well as intramuscular ceftriaxone and topical bacitracin, mupirocin, and polymyxin B. None of these therapies was of benefit.
Downing CP, Woc-Colburn L, Tyring SK. Nasal Erythema and Crusting After a Trip to the Venezuelan Rainforest. JAMA. 2014;312(12):1250-1251. doi:10.1001/jama.2014.3610