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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 344:1461-1466 May 10, 2001 Number 19
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Case 14-2001— A 47-Year-Old Woman with Diabetes, Crohn's Colitis, and a Painful Swelling of the Foot
Harley A. Haynes, Fiona M. Graeme-Cook, and Lisa H. Lerner

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Presentation of Case

A 47-year-old woman was admitted to the hospital for the third time because of a painful, red swelling of the right foot.

Nine months before the third admission, the patient had awoken during the night because of pain in the lower left leg; she suspected that she had been bitten by an insect, possibly a spider. The area became erythematous with draining pustules; a culture yielded rare colonies of coagulase-negative Staphylococcus aureus. Cephalexin and amoxicillin–clavulanic acid were ineffective, and the lesion worsened. The temperature rose to 37.9°C, with chilliness and sweats, and the patient was admitted to this hospital.

The . . . [Full Text of this Article]

Differential Diagnosis

General Characterization of the Skin Lesion

Pyoderma Gangrenosum

            Clinical Types

            Associated Diseases

            Pathogenesis

            Therapy

Conclusions

Clinical Diagnoses

Dr. Harley A. Haynes's Diagnosis

Pathological Discussion

Anatomical Diagnosis

References




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