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June 1986

Fever, Palpable Purpura, and a Positive Weil-Felix Reaction

Author Affiliations

Baylor College of Medicine, Houston; University of Texas Health Science Center, Dallas

Arch Dermatol. 1986;122(6):711-712. doi:10.1001/archderm.1986.01660180117028

REPORT OF A CASE  A 17-year-old previously healthy young man presented with pain and swelling of the left foot. Nine days before, he had noted the onset of myalgias, dizziness, arthralgias, nausea, and vomiting. Six days before admission, he had been treated with intramuscular penicillin and oral cephalosporin for a "swollen finger with lymphangitis and cellulitis." Three days prior to admission, the patient had noted his right knee to be tender with some swelling and warmth. Two days prior to admission, his left foot had become swollen and painful. The patient denied photophobia, known exposure to insects, intravenous drug abuse, urethral discharge, a history of previous venereal disease, or any history consistent with endocarditis. The patient had been brought up in Detroit, and Tennessee; he had been arrested once for attempted murder. He came to Dallas one week prior to his admission.Physical examination revealed a well-developed, illappearing, febrile young