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Symmetrical Hemorrhagic Bullae in an Immunocompromised Host
Darlene S. Johnson, MD;
Terry Hadley, MD;
Martin C. Mihm, Jr, MD
Harvard University Medical School, Boston, Mass
Arch Dermatol. 1999;135:983-988.
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REPORT OF A CASE
A 79-year-old morbidly obese, afebrile, white woman with diabetes and end-stage chronic obstructive pulmonary disease, which was being treated with long-term oral prednisone therapy, was admitted to her local hospital for a presumptive diagnosis of cellulitis of the right arm. She also had a history of elephantiasis with recurrent cellulitis in her lower extremities. Two months earlier, she had been hospitalized for pneumonia. During the interim, family members noted that her right hand, a former intravenous site, continued to drain clear fluid and never healed. A vague history of headache was retrospectively given. Two days before admission, the site on her right hand was noted to have a blue discoloration. Hemorrhagic bullae and erythema of her forearm, with diffuse tenderness, subsequently developed (Figure 1). Therapy with timentin, vancomycin, and gentamicin was initiated for the presumptive diagnosis . . . [Full Text of this Article]
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