Maculopapular Rash and Proteinuria

Abstract

Given the following facts, what is your diagnosis? A 71 year old diabetic on tolbutamide suddenly had a rash that covered most of his body. He became edematous and had 4+ protein in his urine and steadily rising BUN. A skin biopsy showed perivasculitis, and blood cultures yielded staphylococci. Despite steroids and then antibiotics, he died after 24 days in the hospital.