REPORT OF A CASE
A 63-year-old white man was admitted to the hospital with a diagnosis of pulmonary embolus. He had a 1-month history of dyspnea, productive cough, and fevers as well as pleuritic chest pain for 1 day. He had a history of chronic lymphocytic leukemia, hypertension, peripheral vascular disease, autoimmune hemolytic anemia, and non— insulin-dependent diabetes mellitus. His immunosuppressive medications included chlorambucil (10 mg/d) and prednisone (50 mg/d). On admission, he was afebrile, and his skin examination was unremarkable. The chest radiograph showed consolidation of the lateral segment of the right middle lobe. Gram's stain of his sputum revealed gram-positive cocci (3 + ) and a few neutrophils and epithelial cells, but the culture yielded only normal throat flora. Blood cultures were drawn on admission as part of his evaluation for pneumonia and were sterile. A ventilation-perfusion lung scan was performed and indicated that there was a high probability of
House NS, Helm KF, Marks JG. Acute Onset of Bilateral Hemorrhagic Leg Lesions. Arch Dermatol. 1996;132(1):83–84. doi:10.1001/archderm.1996.03890250093016
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