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Edematous Nodules on the Extremities of a Febrile Patient—Quiz Case
J. Scott Boswell, MD;
Antoanella Bardan, MD;
Halliday McDonald, MD;
Amit G. Pandya, MD
University of Texas Southwestern Medical Center, Dallas
Arch Dermatol. 2008;144(12):1651-1656.
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REPORT OF A CASE
A 75-year-old man with systemic polyarteritis nodosa being treated with oral cyclophosphamide was transferred to our hospital with weakness, persistent fevers, and pancytopenia. During the previous 2 weeks at another hospital, he had been treated with broad-spectrum intravenous antibiotics (ticarcillin clavulanate, metronidazole, vancomycin, and levofloxacin), micafungin, and granulocyte-macrophage colony-stimulating factor in an effort to increase his leukocyte count.
Physical examination revealed 5 indurated, edematous nodules on his extremities, 1 near the intravenous catheterization site on his left arm (Figure 1). A tender, stellate, ulcerated plaque was also noted on the hard palate. Laboratory results showed an albumin level of 2.3 g/dL (normal, 3.5-4.5 g/dL); leukocyte count, 0.1 x 103/µL (normal, 4.1-10.9 x 103/µL); hemoglobin level, 8.4 g/dL (normal, 13.5-18.0 g/dL); and platelet count, 10 x 103/µL (normal, 150-440 x 103/µL). . . . [Full Text of this Article]
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Edematous Nodules on the Extremities of a Febrile Patient—Diagnosis
Arch Dermatol. 2008;144(12):1651-1656.
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