<p>An 11-year-old boy presented to the emergency department with a 9-day history of fever to 104.5&deg; F (40.2&deg; C) and a 2-day history of a non-pruritic rash that began on his trunk and spread to all four extremities. The rash was most prominent when he was febrile. He complained of headaches, myalgias, and joint pain, which also worsened with his fevers. After 2 days of fever, before the onset of his rash, he was evaluated and diagnosed with a viral illness and sent home with no further workup or treatment. Over the preceding few weeks, he reported being exposed to stray cats, turtles, and a rat infestation in his backyard. He has a history of bipolar disorder, seizures, and hypothyroidism, for which he takes lithium, levetiracetam, and levothyroxine sodium, respectively.</p>

No abstract

Garlic, Allium sativum L. (Aliaceae), an abundant natural source of sulfur has long been used to treat a number of diseases. Most commercial garlic preparations can be put into one of the following categories: aged garlic, garlic powder or extract, steam-distilled garlic, and garlic macerated in vegetable oils. The antifungal activity of garlic has been attributed to afficin, which forms a variety of degradation products when garlic is processed (1, 2). The aim of this work was to investigate the effect of some commercial garlic products on mycelial growth and the production of biologically active, lanosterol-type triterpenes and fatty acids in Inonotus obliquus (Pers. ex Fr.) Pilat. It has been pointed out earlier that lipid metabolism in yeast and mammals may be affected by allicin (3). The mycehum off obliquus was cultivated in solid and liquid cultures containing commercial garlic preparations in the form of garlic powder capsules or juice, extract, or oil (0.5-10.Og/l). After the growth period, fresh and dry weights were determined. Fungal metabohtes inotodiol, lanosterol, and its C-21 oxygenated derivatives, sterols, and fatty acids were determined using TLC densitometric and GS-MS methods.The investigated garlic-supplemented cultures had antifungal activity and some effect on lipid metabolites.However, the results depended on culture type, garlic product, and concentrations. In this study of different garlic preparations, garlic powder exhibited the strongest growth inhibitory effect. The results obtained from a solid culture are listed in Table 1. In garlic liquid cultures, the main triterpene was inotodiol, foliowed by lanosterol and its C-21 oxygenated derivatives. Garlic juice and extract reduced the amount of free fatty acids in liquid cultures.