LAUSR

CASE REPORT A female patient in her 30s presented with 9 days of a burning, pruritic skin eruption that began on her dorsal forearms and progressed to include her face, chest, and back. She was febrile and had lymphadenopathy, facial edema, and myalgia. She denied arthralgia, sore throat, difficulty breathing or swallowing or mucosal changes. She had recently started a new brand of kava tea, which doubled her previous daily dosage of kavalactone but discontinued it 4 days into symptoms. Physical examination was notable for facial swelling, postauricular lymphadenopathy and erythematous papules coalescing into plaques on the face, arms, thighs, chest, abdomen, and back (Fig 1, A and B). Laboratory results were significant for an elevated white blood cell count of 11600 cells/ L (reference range, 4500-11000 cells/ L), eosinophil count of 890 cells/ L (reference range, 0-450 L), neutrophil count of 8900 cells/ L (reference range, 1800-7800), aspartate aminotransferase of 85 U/L (reference range, 10-30 U/L), and alanine aminotransferase of 222 U/L (reference range, 10-40 U/L). The patient had normal thyroid studies and negative blood