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Images in Dermatology
February 19, 2020

Unilateral Septic Emboli From an Infected Pseudoaneurysm

Author Affiliations
  • 1Southern Illinois University School of Medicine, Springfield
  • 2Division of Dermatology, Southern Illinois University School of Medicine, Springfield
JAMA Dermatol. 2020;156(4):452. doi:10.1001/jamadermatol.2019.4927

A man in his 60s was admitted with a 3-day history of right lower extremity pain, edema, weakness, and rash. His medical history was significant for an untreated oral abscess 2 months previously as well as an unremarkable coronary angiogram performed via the right common femoral artery 9 years ago. On examination, he was febrile, with unilateral right lower extremity edema, weakness, tenderness, and purpuric macules and papules (Figure 1). Multiple blood cultures were positive for Streptococcus dysgalactiae. Unilateral localization of cutaneous lesions suggested a locoregional source of septic emboli. Computed tomography angiography showed a pseudoaneurysm of the right common femoral artery compressing the right femoral vein, which contained a partially occlusive thrombus (Figure 2). A transesophageal echocardiogram was unremarkable.

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