I am caring for a pregnant women who came into our unit today with
complaint of not feeling well, nauseated over the last 2 days.  She is
flushed, temp 98.8 orally. Has been treated for a breast infection over the
past week with Keflex.  She stated that she has been having problems since
the beginning of May.  She had been treated with Zithromax shortly before
this for some respiratory symptoms.  Also states she was scratched by her
cat around this time, didn't cause bleeding but did have ascratch mark on
the right breast.  the cat is an indoor cat and is up to date on it's
vaccinations.  Her breasts are edematous bilaterally, light pink, warm to
the touch, the tips of the nipples appear to be light brown, almost like
sore nipples starting to heal.  There are small "pox marks" or craters,
like orange peel with in the pink area.  Her areola have lost color and are
almost white in appearance.  She states that the skin is flaky and if she
wears a black bra you can see flakes of dry skin in it.  No drainage from
the nipples.  She has been applying aloe vera lotion to her breasts.
States she doesn't have a yeast infection but has had one in the past, not
during the pregnancy.  Did have gardenerella alot before she was pregnant
and was treated but not during the pregnancy.  The doctor ordered IV
Rocefin.  Any ideas on what this might be?  thank you for your thoughts

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