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June 20, 2011

Erythema Nodosum–Like Lesions in a Renal Transplant Recipient—Diagnosis

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Arch Dermatol. 2011;147(6):735-740. doi:10.1001/archdermatol.2011.128-b

Histopathologic examination revealed epidermal spongiosis and liquefactive necrosis of the upper dermis admixed with numerous amebic trophozoites (Figure 2). The trophozoites were identified by the eccentric small nuclei with a central karyosome and abundant cytoplasm with vacuolation and ingested erythrocytes (Figure 3). The patient was thought to have a disseminated cytomegalovirus infection and was treated with intravenous ganciclovir sodium for 2 weeks. She also received intravenous meropenem. Her condition deteriorated, however, and she died before the diagnosis of invasive amebiasis was made by means of histopathologic examination and tissue culture.

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