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JAMA Dermatology Clinicopathological Challenge
June 2015

Skin Leg Ulcer in an Immunocompromised Patient With Pseudomonas aeruginosa Sepsis

Author Affiliations
  • 1Department of Dermatology, Hospital Arnau de Vilanova, Valencia, Spain
  • 2Department of Pathology, Hospital Arnau de Vilanova, Valencia, Spain
JAMA Dermatol. 2015;151(6):661-662. doi:10.1001/jamadermatol.2014.5110

A man in his 60s presented with a painless rapidly enlarging ulcer on his left leg 1 week after the onset of diverticulitis, a neutropenic fever, and severe sepsis due to multidrug-resistant Pseudomonas aeruginosa infection that necessitated admission to the intensive care unit. His medical history included a heart transplant for ischemic cardiomyopathy in his early 50s, and he was receiving long-term immunosuppressive therapy with cyclosporine, mycophenolate mofetil, and deflazacort. He had received a diagnosis of plasmablastic lymphoma 6 months earlier and was being treated with polychemotherapy (cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisone [CHOP] regimen).

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