The Infamous Nevirapine Rash

It has been 4 days since I had fever, the longest time I have ever encountered. And as far as my adult mind could remember, my temperature on the 2nd night of fever was the highest temperature I ever recorded, 40.2oC. Good thing it was planned that I am supposed to go to RITM on Friday (3rd day of my fever) intended for my refill, and to meet with a new found friend, EU.

I first encountered EU as a blogger who left a comment on one of my entries. To make the story super short (plus basing on his comment), we were able to get in touch and we planned to meet in RITM, for his CBC and refill, and for my supposedly refill. And it happened that I got fever, the more that I need to go to RITM.

Friday morning came, and it wasn't really a comfortable sleep. My sleep was very light and I had to empty my bladder too often since I've been drinking lots of water. I woke up at around 5:15am, too early from the time I set the alarm. I slept again. 5:45am, my alarm told me to wake up, but I was too weak I decided to curl myself up like a fetus (a bit uncomfortable position so that I could be awakened even by the lightest stimuli) and tried to get little more time of sleep. 6:15am, okay, okay, I really have to get up. Struggle!

With all the strength I could muster, I stood up, opened the lights, checked my temperature (39.4oC), prepared my morning meds, and noticed something that wasn't there before, small, flat, reddish marks on my forearms. I got the infamous Nevirapine rash. They were still few and unnoticeable at one glance. Some rashes were also breaking out in my chest. Oh no, I won't be able to go topless around the house. Then, I tried to fix myself at the fastest pace I can. I was running late already. But I know he'd understand. :)

I arrived late in RITM, walked down straight to ARG, and saw 2 guys talking to each other outside the building. They were sitting on that I-don't-know-what concrete thingy (because I seldom pay attention to that place). I easily noticed Kuya Bobby. The other guy, I could only see his back, but immediately noticed some of his permanent marks on his arms, and yes, it's him, EU. He really has a resemblance with my cousin, only my cousin's eyes are more chinese-looking. I stopped by their place, greeted them both and went down to ARG.

It was a quick wait. I got checked by Doc Mark several minutes after. I told him what happened from the fever to the rashes. The fever must have been caused by IRIS, since I'm on ARVs already, my immune system begins to regain its function however it also causes increase in inflammatory response, thus the fever, he explained. For that, he gave me Prednisone. And as for the rashes, no doubt it was caused by Nevirapine. He then shifted me to Efavirenz. (Okay, I promised myself I won't go talking about its side effects anymore. May be I won't have it if I don't talk about it. I was too worried with my Nevirapine that I might get rashes, and true enough, I did get rashes.)

I wanted to see their Dermatologist but I'd be lacking time, I still have to do something in the afternoon. So I decided to visit Derma clinic some other day.

When both our businesses in RITM were done, EU and I had lunch at Shakey's, in Alabang Town Center. Everything in my plate was tasteless (blaming it on the fever), except for the garlic bread which I was able to recognize the taste. Even the chicken was unpalatable but I feasted on it anyway just to fill my stomach with food. The pasta was the worst. It was unpleasant. We finished the meal faster than it was served and left. Oh, of course we paid, and didn't wait for the change. 

Before parting ways, I was able to meet Froy, EU's partner. EU helped me find my way to get back to Alabang Market since I am really an alien in that side of Metro Manila. And I'm not really good with directions. (Honestly, I only know Manila City, true-blood Manileno at your service.)

I still got one more thing to do, and yet I already felt weak. I had my CBC done as per mom's request. She's been persistently telling me to have my blood test done so I may know what's causing my fever. So to grant her heart's desire, I have it checked.

I arrived home looking very different from the way I looked when I left. Rashes were getting plentiful, too plenty that I looked like I got sun-tanned under a very, very fine chicken wire. There was no chance I'd be able to hide it. I told them it's some sort of a viral exanthem, a nonspecific one. They won't be forcing me to take antibiotic (which I really didn't take when they asked me to on the 2nd day of my fever) since it's viral in origin.

After a very fast explanation, I went to my room, hugged my Goofy bed, took my evening meds plus my first dose of Prednisone. After that. I  was too tired to get up or even move a muscle.

My dad followed and checked on me. He was wiping my face and arms with a small wet towel, and stayed there for quite awhile as I lay silently still. I actually didn't notice when he left. All I remembered was that I left my bag open with my newly-harvested ARV bottles inside it. I just do hope he didn't see it.

Still in bed that night, febrile.
Nevirapine-rash covered body.
ATP-drained.

 

As of writing, my temperature is now back to normal, which means I can start with the Efavirenz tonight unless I get febrile anytime again today. Still with the Nevi rashes, not much has changed from its appearance. I have regained my strength back. I can do push-ups again. Yey! And most importantly, I got my taste buds working again. I miss food!

P.S. I know my links are all leading you to Wikipedia, not a very credible source of info but nonetheless, the explanations are very easy to comprehend, as they use less jargons. You just have to know the gist.

P.S. ulit. (February 26, 2015) Today, I finally decided or should I say I finally found time to put my nevirapine rash photos here in my own blog. Ayaw ko pa dati. Arte-artehan pa ako, ipopost ko rin pala.

Forearm. Left side is the proximal (elbow) part while right side is the distal (wrist) part.

My thigh. The rashes in this two photos are still mild.

These last two photos are full blown nevirapine rashes.

Aja!