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December 1994

Fever, Maculopapular Eruption, and Lymphadenopathy

Author Affiliations

DeKalb Medical Center, Decatur, Ga (Drs Gross, Kagan, Hargreaves, Freedman, Botstein, and Fine) and Emory University Affiliated Hospitals, Atlanta, Ga (Drs Fine and Botstein)

Arch Dermatol. 1994;130(12):1551-1552. doi:10.1001/archderm.1994.01690120091013

REPORT OF A CASE  A 56-year-old white woman was admitted following 3 weeks of fever, lymphadenopathy, and a rash of unknown origin unresponsive to oral doxycycline. Physical examination revealed a mildly tachypneic, ill-appearing woman with a temperature of 38.2°C. An extensive eruption of discrete and coalesced erythematous maculopapular skin lesions was noted on the face, trunk, and extremities (Figure 1 ). Enlarged tender lymph nodes were palpated in the anterior cervical, posterior cervical, axillary, and inguinofemoral regions. No significant enlargement of the liver or spleen was detected. The remainder of the physical examination was essentially normal.Laboratory evaluation revealed the following: hemoglobin, 128 g/L; leukocytes, 9.6 X109/L, with 0.39 segmented forms, 0.21 band forms, 0.17 lymphocytes, 0.18 eosinophils, and 0.05 atypical lymphocytes; platelets, 404×109/L; serum protein, 92 g/L; serum albumin, 34 g/L; Westergren erythrocyte sedimentation rate, 60 mm/h; serum protein electrophoresis, polyclonal gammopathy, and blood cultures, negative. The following

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